On Monday a highly influential government panel of experts says that older smokers at high risk of lung cancer should receive annual low-dose CT scans to help detect and possibly prevent the spread of the fatal disease.
In its final word on the issue published Dec. 30, the U.S. Preventive Services Task Force (USPSTF) concluded that the benefits to a very specific segment of smokers outweigh the risks involved in receiving the annual scans, said co-vice chair Dr. Michael LeFevre, and a distinguished professor of family medicine at the University of Missouri.
Specifically, the task force recommended annual low-dose CT scans for current and former smokers aged 55 to 80 with at least a 30 “pack-year” history of smoking who have had a cigarette sometime within the last 15 years. The person also should be generally healthy and a good candidate for surgery should cancer is found, LeFevre said.
About 20,000 of the United States‘ nearly 160,000 annual lung cancer deaths could be prevented if doctors follow these screening guidelines, LeFevre said when the panel first proposed the recommendations in July. Lung cancer found in its earliest stage is 80 percent curable, usually by surgical removal of the tumor.
“That’s a lot of people, and we feel it’s worth it, but there will still be a lot more people dying from lung cancer,” LeFevre said. “That’s why the most important way to prevent lung cancer will continue to be to convince smokers to quit.”
Pack years are determined by multiplying the number of packs smoked daily by the number of years a person has smoked. For example, a person who has smoked two packs a day for 15 years has 30 pack years, as has a person who has smoked a pack a day for 30 years.
. These can be resolved through screening, but that adds to the number of radiation exposures a patient will receive.
The panel also had to weigh whether their recommendation would send the message to smokers that they now don’t have to quit because screening measures will prevent their death from lung cancer.
“The main message of all this should be that you should stop smoking,” said former lung association board chair Rizzo, who is section chief of pulmonary/critical care medicine at Christiana Care Health System in Newark, Del.