More Americans now qualify for annual lung cancer screening, according to guidelines released on Tuesday that can help more black smokers and women get screened.
Lung cancer is the main cause of cancer in the country, causing more than 135,000 deaths each year. Smoking is the main cause and quitting is the best protection.
Usually, lung cancer is diagnosed too late for a good chance of survival. But some Americans who are at particularly high risk have a low-dose CT scan, a type of X-ray, to improve those chances.
Who is eligible?
The US Preventive Services Task Force said that anyone between 50 and 80 years old who smoked at least 20 “pack-years” and still smoked or stopped in the past 15 years. A “pack-year” means smoking a pack of cigarettes a day for a year or an equivalent amount. Thus, one could qualify by examining one pack a day for 20 years or two packs a day for 10 years.
Since 2013, the exams are recommended for heavier smokers – 30 pack years – and slightly older, from 55 years old. The task force updated the guidelines, published Tuesday in the Journal of the American Medical Association, after more recent surveys have shown lighter and younger smokers also benefit. It is estimated that about 15 million people meet the new criteria, almost double the previous number.
The task force’s recommendation means that insurers should offer non-co-pay screening to people who meet the criteria.
The changes “mean that more blacks and women are now qualified to screen for lung cancer, which is a step in the right direction,” said Dr. John B. Wong, a member of the Tufts Medical Center task force, in an announcement.
The panel said that African-Americans and women tend to be less smokers and may not have reached the initial screening limit, despite being at risk for lung cancer.
In an editorial by JAMA Surgery, cancer experts welcomed the changes.
But “unfortunately, reducing age and pack-year requirements alone does not guarantee greater equity in lung cancer screening,” wrote Dr. Yolonda Colson and colleagues at Massachusetts General Hospital.
His team noted “formidable” barriers, including poor access to health care and even doctors who are not familiar enough with screening to identify good candidates and help them decide.
A recent study found that only 14 percent of people eligible for lung cancer screening under previous guidelines had actually succeeded. In contrast, 60% to 80% of people eligible for breast, colon or cervical cancer screening are screened.
People undergoing lung cancer screening should also consider the risks of invasive testing to see if any abnormalities detected by the screening are actually a tumor. Lung biopsies occasionally cause serious, even fatal, complications.