ASCO, ACCP issue lung-cancer screening guidelines
MedWire News: The American College of Chest Physicians (ACCP) and the American Society for Clinical Oncology (ASCO) have issued joint guidelines regarding the use of computed tomography in lung cancer screening.
The guidelines recommend annual screening with low-dose CT in current and former smokers aged from 55 to 74 years who have smoked for at least 30 pack-years (cigarette packs smoked per day multiplied by years of smoking) and who, if they no longer smoke, quit within the last 15 years.
The recommendations are based on a systematic review conducted by a panel of experts from ASCO, ACCP, the American Cancer Society, and the National Comprehensive Cancer Network. The review is published online in JAMA.
"We found that CT screening has the potential to reduce lung cancer deaths in some smokers and former smokers when utilized appropriately, but there are many unanswered questions about its risks and whether it will work as well in clinical practice as it has in carefully conducted trials. We have gathered what is known to date and summarized it, and encourage physicians, patients and policy makers to consider the guideline and the evidence on which it is based," said Peter Bach (Memorial Sloan-Kettering Cancer Center, New York City, USA), chair of the expert panel, in a statement. "This is a technology whose benefits we will only fully realize with appropriate use and infrastructure. We concluded that establishing a registry that records each patient's experience could help us develop a quality measurement system similar to mammography screening that could maximize the benefits and minimize the harm for individuals who undergo screening," the statement continues.
The guidelines recommend against the routine use of CT screening in smokers with fewer than 30 pack-years, those aged younger than 55 years or older than 74, and those who kicked the habit more than 15 years ago. The guidelines also note that "in individuals with severe comorbidities that would preclude potentially curative treatment, limit life expectancy, or both, we suggest that CT screening should not be performed."
By Neil Osterweil