Low-dose computed tomography (CT) for lung cancer screening in high-risk adults over 40 years with significant smoking exposure reduces lung-cancer mortality.[40]Aberle DR, Adams AM, Berg CD, et al; National Lung Screening Trial Research Team. Reduced lung cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011 Aug 4;365(5):395-409.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356534
http://www.ncbi.nlm.nih.gov/pubmed/21714641?tool=bestpractice.com
[41]de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med. 2020 Feb 6;382(6):503-13.
https://www.nejm.org/doi/10.1056/NEJMoa1911793
http://www.ncbi.nlm.nih.gov/pubmed/31995683?tool=bestpractice.com
[42]Bonney A, Malouf R, Marchal C, et al. Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality. Cochrane Database Syst Rev. 2022 Aug 3;8(8):CD013829.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9347663
http://www.ncbi.nlm.nih.gov/pubmed/35921047?tool=bestpractice.com
Detecting early-stage small cell lung cancer (SCLC) is complicated by its relative rarity and aggressive nature (which may prohibit detection of SCLC at a potentially curable stage).[43]US Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, et al. Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021 Mar 9;325(10):962-70.
https://jamanetwork.com/journals/jama/fullarticle/2777244
http://www.ncbi.nlm.nih.gov/pubmed/33687470?tool=bestpractice.com
Recommendations
The US Preventive Services Task Force (USPSTF) and the American College of Radiology recommend annual low-dose CT in:[44]American College of Radiology. ACR appropriateness criteria: lung cancer screening. 2022 [internet publication].
https://acsearch.acr.org/docs/3102390/Narrative
[43]US Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, et al. Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021 Mar 9;325(10):962-70.
https://jamanetwork.com/journals/jama/fullarticle/2777244
http://www.ncbi.nlm.nih.gov/pubmed/33687470?tool=bestpractice.com
The USPSTF recommends that screening should be stopped when a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the likelihood of having curative lung surgery.[43]US Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, et al. Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021 Mar 9;325(10):962-70.
https://jamanetwork.com/journals/jama/fullarticle/2777244
http://www.ncbi.nlm.nih.gov/pubmed/33687470?tool=bestpractice.com
The National Comprehensive Cancer Network recommends screening for lung cancer with low-dose CT in high-risk adults:[45]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: lung cancer screening [internet publication].
https://www.nccn.org/guidelines/category_2
Shared decision-making is recommended in candidates for screening, including a discussion of the benefits and risks involved.[45]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: lung cancer screening [internet publication].
https://www.nccn.org/guidelines/category_2
The American Cancer Society recommends annual low-dose CT in people:[46]American Cancer Society. Lung cancer screening guidelines. Jan 2024 [internet publication].
https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/lung-cancer-screening-guidelines.html
Ages 50 to 80 years, with
At least a 20-pack-year smoking history, who
Currently smoke or have previously smoked.