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21 March 2012


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Current screening rticmmendaeoonsAt this time, no major professional organizations, including the American Cancer Society, recommend routine lung cancer screening, either for all people or for those at increased risk. However, as the results from the NLST are further analyzed, some organizations may update their rticmmendaeoons in the near future. In the meantime, some people who are at higher risk (and their doctors) may consider whether screening is appropriate for them.While a full cancer screening guideline is being developed, the American Cancer Society has created interim guidance for people and their doctors regarding the use of low-dose CT scans for the early detection of lung cancer:•People between the ages of 55 and 74 who meet the entry criteria of the NLST (see above) and are concerned about their risk of lung cancer may consider screening for lung cancer. With their doctor, people interested in screening should weigh the currently known benefits of screening with the currently known limits and risks in order to make a shared decision as to whether they should be screened for lung cancer.•Doctors may choose to discuss lung cancer screening with their patients who meet NLST entry criteria.•For people who do not meet the NLST entry criteria (because of younger age, smoking history, etc.), it is not clear if the possible benefits of screening outweigh the harms, so screening in these people is not recommended at this time. This is especially the case among people with no smoking history, in whom the possible harms are much more likely than benefits at this time. Whether people whose age or smoking history would have made them ineligible for the NLST should be screened will be addressed during the guidelines development process as more data becomes available.•People who choose to be screened should follow the NLST protocol for annual screening. This should be done in an organized screening program at an institution with expertise in spiral CT screening, with access to a multidisciplinary team skilled in finding and treating abnormal lung lesions. Referring doctors should help their patients find institutions with this expertise.•There is always benefit to quitting smoking. Active smokers entering a lung screening program should be urged to enter a smoking cessation program. Screening should not be viewed as an alternative to quitting smoking.•For people considering screening (and their doctors), some statistics from the NLST may be helpful. Of the nearly 26,000 people screened by low-dose CT in the NLST, 1,060 were diagnosed with lung cancer. Screening is estimated to have prevented 88 lung cancer deaths while causing 16 deaths. Six of the 16 deaths were in patients who ultimately were found not to have cancer.

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