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USPSTF Drafts Recommendations for Annual CT Screening for Lung Cancer

The United States Preventive Services Task Force (USPSTF) has updated its guidelines to include annual low-dose computed tomography (CT) scans for individuals who are at a high-risk for developing lung cancer. The updates are still in progress and are not considered to be a final determination as of yet. A full draft of these updated considerations can be found at: http://www.uspreventiveservicestaskforce.org/draftrec.htm. The data that were considered for this recommendation can be found at: http://annals.org/article.aspx?articleid=1721248.

Lung cancer remains the leading cause of cancer-related deaths in the United States. At present, no effective screening measure for the disease exists, so the majority of lung cancers are detected once they’ve spread from the lungs to different sites of the body. Once the cancer has spread, standard therapies rarely result in a cure.

Therefore, screening so that lung cancer can be detected and treated prior to spread from the lungs is imperative to improve survival rates.

Large studies have demonstrated that annual screening with low-dose computed tomography (CT) improves survival from lung cancer compared to those screened with a chest x-ray. However, the cost, anxiety and the rate of false-positives leading to subsequent unnecessary tests have impeded the medical community in accepting the screening method into standard guidelines.

Recently, the USPSTF reevaluated data to further explore the benefits versus potential harms in low-dose CT screening for individuals who are considered to be at a high risk of developing lung cancer. Researchers evaluated data from clinical trials around the world including low-dose CT screening for individuals who were smokers or former smokers.

Overall, the USPSTF gave a grade B recommendation for annual low-dose CT screening for individuals who have a 30-pack year smoking history within their lifetime, aged 55-79 years. Chest x-rays and sputum cytology were not included in the updated proposed recommendations.

A grade B from the panel means “The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.”

The USPSTF grades recommendations according to evidence-based data. Under the Affordable Care act, insurance companies are required to pay for USPSTF A or B recommendations.

When the final draft of these recommendations are officially integrated into USPSTF guidelines, any individual who is a current or former smoker should speak with their healthcare provider regarding screening.

References:

U.S. Preventive Services Task Force. Draft Recommendation Statement. Available at: http://www.uspreventiveservicestaskforce.org/draftrec.htm. Accessed July 31, 2013.

Humphrey L, Deffebach M, Pappas M, et al. Screening for lung cancer with low-dose computed tomography: a systematic review to update the U.S. Preventive Services Task Force Recommendation. Annals of Internal Medicine. Published online 30 July 2013 doi:10.7326/0003-4819-159-6-201309170-00690