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USPSTF recommends lung cancer screening for some smokers

Clinical Question:
What are the United States Preventive Services Task Force recommendations for screening smokers for lung cancer?

Bottom Line:
The United States Preventive Services Task Force (USPSTF) recommends annual low-dose computed tomography for all smokers aged 55 years to 80 years who have a 30 pack-year smoking history and who have smoked within the past 15 years. (LOE = 5)

Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2014;160:330-338.  [PMID:24378917]

Study Design:
Practice guideline


Various (guideline)

Emphasizing that screening is not a substitute for smoking cessation, the USPSTF recommends screening for patients at high risk, with the idea that early-stage non–small cell lung cancer can be detected and treated with surgical resection. This is a B recommendation, moderate certainty of benefit. The largest study, the National Lung Screening Trial, found a 16% reduction in lung cancer mortality and a 6.7% decrease in all-cause mortality in adults aged 55 years to 74 years who had at least a 30 pack-year history of smoking. False positive results are common, and 95% of positive results will not be lung cancer on subsequent imaging. There is also a risk that 10% to 12% (20% in another study) of lung cancers will be overdiagnosed, which means they would not have been detected or have caused harm in a patient's lifetime had they not been identified by screening. Cost, which could be substantial, was not a part of the decision-making process.


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