Lung cancer

CHEST Group Releases Updated Lung Screening Guidelines

The American College of Chest Physicians has released draft guidelines on the screening of patients for lung cancer.

Specifically, the guidelines seek to update evidence on the benefits, harms, and implementation of low radiation dose chest CT screening.
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Among the recommendations:

  • Annual screening with low-dose CT should be offered to asymptomatic smokers and former smokers aged 55 to 77 years who have smoked 30 pack years or more.
  • Low-dose CT screening should not be performed in patients with comorbidities that adversely influence the ability to tolerate the evaluation of screen detected findings.
  • Screening programs should define what constitutes a positive test based on the size of detected solid or part-solid lung nodules.
  • Strategies should be developed to minimize overtreatment of potentially indolent lung cancers.

“Evidence suggests that low-dose CT screening for lung cancer results in a favorable but tenuous balance of benefit and harms. The selection of screen-eligible patients, the quality of imaging and image interpretation, the management of screen detected findings, and the effectiveness of smoking cessation interventions, can impact this balance. Additional research is needed to optimize the approach to low-dose CT screening,” the researchers concluded.

—Michael Potts

Reference:

Mazzone PJ, Silvestri GA, Patel S, et al. Screening for lung cancer: CHEST guideline and expert panel report [published online November 3, 2017]. CHEST. http://info.chestnet.org/screening-for-lung-cancer-chest-guideline-and-expert-panel-report.