From the Guidelines
Annual low-dose CT scans for lung cancer screening are recommended for asymptomatic individuals aged 55-77 who have smoked 30 pack-years or more and either continue to smoke or have quit within the past 15 years. This recommendation is based on the strongest and most recent evidence from the Chest guideline and expert panel report 1. The guideline suggests that annual screening with low-dose CT should be offered to these individuals, as it has been shown to reduce lung cancer mortality by early detection.
For individuals who do not meet the above criteria, but are aged 50-80, have smoked 20 pack-years or more, and either continue to smoke or have quit within the past 15 years, annual screening with low-dose CT may be considered 1. However, the decision to screen should be made on an individual basis, taking into account the person's overall health and life expectancy.
It's also important to note that smoking cessation is the most important intervention to prevent lung cancer, and current smokers should be informed of their continuing risk for lung cancer and offered cessation treatments 1. Patients should discuss their individual risk factors with their healthcare provider to determine if screening is appropriate for them.
Some key points to consider when determining eligibility for lung cancer screening include:
- Age: 55-77 years for the highest risk group, and 50-80 years for the moderate risk group
- Smoking history: 30 pack-years or more for the highest risk group, and 20 pack-years or more for the moderate risk group
- Current smoking status: continuing to smoke or having quit within the past 15 years
- Life expectancy: individuals with a life expectancy of at least 10 years may benefit from screening
- Ability to undergo curative lung surgery: individuals who are not candidates for surgery may not benefit from screening.
From the Research
Eligibility Criteria for Low-Dose CT Scan
The following individuals should consider having a low-dose CT scan to rule out lung cancer:
- Current or past tobacco smokers who meet specific criteria, as demonstrated by clinical trials that have shown a mortality benefit from lung cancer screening by low-dose CT (LDCT) in these populations 2
- Asymptomatic high-risk individuals, as identified in various studies that suggest LDCT may be effective in detecting lung cancer at an early stage in this group 3, 4, 5
High-Risk Population
A high-risk population for lung cancer includes:
- Individuals aged 55 to 80 years, as identified in a study that used the Clinformatics Data Mart national database to assess rates of follow-up imaging and diagnostic procedures after screening LDCT 2
- Those with a history of tobacco smoking, as tobacco smoking is a well-established risk factor for lung cancer 3, 6
Screening Recommendations
While there is evidence to support the use of LDCT for lung cancer screening in high-risk populations, the decision to undergo screening should be made on an individual basis, taking into account the potential benefits and harms of screening, including the risk of false-positive findings and downstream evaluation of abnormal screens 2, 4, 5