Panel issues guidelines for lung cancer CT scans
CHICAGO – New lung cancer screening guidelines from three medical groups recommend annual scans but only for an older group of current or former heavy smokers.
The advice applies only to those aged 55 to 74. The risks of screening younger or older smokers or nonsmokers outweigh any benefits, according to the guidelines.
About 8 million Americans would be eligible for screening under the new criteria, and if all of them got the scans, about 4,000 lung cancer deaths per year could be prevented, said Dr. Peter Bach of Memorial Sloan-Kettering Cancer Center in New York.
He chaired the expert panel that wrote the new guidelines for the American College of Chest Physicians, the American Society of Clinical Oncology and the National Comprehensive Cancer Network.
The recommended screening involves low-dose CT scans, which are a special kind of X-ray that can detect lung cancer early, but also can have false-positive results.
Regular chest X-rays can also detect lung cancer but they provide less detailed images than CT scans, can also have false-positive results and have not been recommended as a screening tool because they have not been shown to save lives.
The guidelines were published online Sunday in the Journal of the American Medical Association.
Widespread screening will likely lead to some deaths because abnormal results are typically followed by biopsies and other invasive tests that sometimes have deadly complications. Still, the three groups say those deaths would be far outnumbered by people saved from lung cancer deaths by screening.
The new guidelines say screening with low-dose CT scans should be offered, but only in academic medical centers and other sites with specialized radiologists and surgeons on staff.
The guidance is based on a review of evidence including a large National Cancer Institute study involving more than 53,000 people with a history of smoking at least one cigarette pack daily for 30 years or two packs for 15 years. The guidelines recommend screening only for people who have smoked that much.
Dr. Otis Brawley, chief medical officer at the American Cancer Society, took part in the new review and said his group likely will issue separate permanent guidelines later this year. The cancer society doesn’t issue joint guidelines or endorse other group’s guidelines, Brawley said.
“Screening is a double-edged sword,” Brawley said. CT screening prevented about 80 lung cancer deaths over six years in the National Cancer Institute study, but 16 study participants died after CT screening, including six who did not have lung cancer.