Chest docs advise CT screening for lung cancer in high-risk patients

Updated guidelines from the American College of Chest Physicians (ACCP) on the diagnosis and management of lung cancer now include a recommendation to offer low-dose computed tomography (LDCT) scanning to persons who are at high risk for lung cancer due to their age and smoking history.

The recommendation is based on a systematic review of data that shows an important reduction in deaths from lung cancer when screening is done in an organized program, according to an ACCP statement summarizing the guidelines. In the statement, the ACCP notes that this position represents a clear change from the guidelines issued in 2007, when such evidence was not available.

The ACCP describes lung cancer screening as a complex interplay of a person's risk and many other key factors, including how LDCT scanning is performed and interpreted.

“Lung cancer screening offers a potential benefit for select individuals, but it is not a substitute for stopping smoking,” cautioned ACCP guidelines panel vice-chair Frank Detterbeck, MD, FCCP, of Yale University in New Haven, Connecticut, in the statement. “However, screening is not a scan; it is a process.”

As previously reported by Oncology Nurse Advisor, January 2013 guidelines from the American Cancer Society (ACS) advised clinicians to recommend annual lung cancer screening by means of LDCT for high-risk patients if both provider and patient meet certain conditions.

The ACCP has included more than 275 other recommendations in its Diagnosis and Management of Lung Cancer, 3rd Edition: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, published this month as a supplement to the journal Chest (May 2013;143[5_suppl]. In addition to screening, the guidelines address such topics as treatment of tobacco use, management and palliation of lung cancer symptoms, treatment advances, and the most recent lung cancer staging system as well as the methods for staging.

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