The NLST was a large study, but it left some questions that still need to be answered. For example, it’s not clear if screening with LDCT scans would have the same effect if different people were allowed in the study, such as those who smoke less (or not at all), or people younger than age 55 or older than 74. Also, in the NLST, patients got 3 scans over 2 years. It’s not yet clear what the effect would be if people were screened for longer than 2 years.
These factors, and others, need to be taken into account by people and their doctors who are considering whether or not screening with LDCT scans is right for them.
American Cancer Society guidelines for lung cancer screening
The American Cancer Society has thoroughly reviewed the subject of lung cancer screening and issued guidelines that are aimed at doctors and other health care providers:
Patients should be asked about their smoking history. Patients who meet ALL of the following criteria may be candidates for lung cancer screening:
55 to 74 years old
In fairly good health (discussed further down)
Have at least a 30 pack-year smoking history (discussed above)
Are either still smoking or have quit smoking within the last 15 years
These criteria were based on what was used in the NLST.
Doctors should talk to these patients about the benefits, limitations, and potential harms of lung cancer screening. Screening should only be done at facilities that have the right type of CT scanner and that have a lot of experience using LDCT scans for lung cancer screening. The facility should also have a team of specialists that can provide the appropriate care and follow-up of patients with abnormal results on the scans.
Published on
July 29, 2014
Dr. Sidhu Gangadharan, Chief of Thoracic Surgery in the Chest Disease Center at BIDMC, discusses lung cancer screening for high-risk individuals and how it could help save lives.
... continued from page 23
Page 24