These changes to the guidelines “will enable more people to get screened overall, and, importantly, have particular implications for certain groups of individuals,” Dr. Mara Antonoff, an associate professor of thoracic and cardiovascular surgery at The University of Texas MD Anderson Cancer Center, who is not involved in the USPSTF, told CNN ahead of the release of the task force’s recommendations.
Antonoff added that the revised guidance will allow more women and Black patients to be screened for lung cancer.
Data show that women and Black people tend to smoke fewer cigarettes than White men — so expanding who is eligible for screening may help to include those groups. There are also higher rates of lung cancer in the Black community even though they have lower smoking rates, smoke fewer cigarettes per day, and are less likely to be heavy smokers, according to the National Institute on Minority Health and Health Disparities.
The guidelines recommend to “stop screening once a person has not smoked for 15 years or has a health problem that limits life expectancy or the ability to have lung surgery.”
‘We can save more lives’
The new recommendation is based on an updated evidence report and review of 223 previously published studies. The report found that screening high-risk people can reduce the risk of lung cancer death, but also warned that there is the risk of false-positive results.
“The task force reviewed new evidence that shows screening can help many more people who are at high risk for lung cancer,” USPSTF member Dr. Michael J. Barry said in a news release on Tuesday. “By screening people who are younger and who have smoked fewer cigarettes, we can save more lives and help people remain healthy longer.”
More screening is needed, experts say
The update of the USPSTF recommendation expands the population eligible for lung cancer screening from an estimated 14.1% to 22.6%, according to an editorial that published in the journal JAMA Oncology on Tuesday.
Another editorial, published in the journal JAMA Network Open on Tuesday, notes that “an eligibility expansion alone” is not enough to increase lung cancer screening rates and resolve disparities. Rather, broad and more equitable screening is needed.
Only a small proportion — about 2% to 16% — of eligible patients get screened for lung cancer, Dr. Anne Melzer and Dr. Timothy Wilt, both of the University of Minnesota Medical School, wrote in the editorial. They added that breast and colon cancer screening rates approach 70%.
For lung cancer screening to be as effective as possible, “implementation guides stress the importance of formal programs, including eligibility confirmation, effective patient tracking, adherence to structured nodule reporting and evaluation, and access to a multidisciplinary committee of clinical specialists,” Melzer and Wilt wrote.
“These subspecialists may be in short supply in lower-resource settings but are necessary to minimize unnecessary invasive testing and to promptly diagnose and treat identified cancers.”