Guidelines: screen for lung cancer with low-dose CT

The American Association for Thoracic Surgery (AATS) is calling for annual lung cancer screening using low-dose computed tomography (LDCT) for North Americans aged 55 to 79 years with a 30 pack-year history of smoking in new guidelines published in Journal of Thoracic and Cardiovascular Surgery (2012;144:33-38).

The AATS also recommends that persons age 50 years and older with a 20 pack-year history undergo annual screening for lung cancer with LDCT if they have an additional cumulative risk of developing lung cancer of 5% or greater over the following 5 years. In addition, long-term survivors of lung cancer, defined as persons who have been treated for a primary bronchogenic carcinoma and have completed 4 years of radiographic surveillance without evidence of recurrence, should undergo annual LDCT to detect second primary lung cancer until they reach age 79 years.

“At this time and for the first time in medical history, we can say, ‘lung cancer screening—the time has come,'” wrote Michael T. Jaklitsch, MD, of Brigham and Women's Hospital, Boston, Massachusetts, and the other members of the AATS task force that developed the guidelines. The group credits LDCT for providing a useful screening method that has been proven to increase the survival of persons with lung cancer.

The AATS guidelines differ from those put forth by other organizations not only because the new document addresses survivors of lung cancer, but also because screening is recommended for persons up to age 79 years. Other societies recommend screening for patients only up to age 74 years. However, noted the AATS guideline authors, screening should not be performed in individuals of any age who have comorbidities or functional status that would prevent them from getting adequate treatment.