If You Smoke a Pack a Day, Lung Cancer Screening Should Start at Age 50 & Be Free, Say New Federal Recommendations

"The expansion of lung screening eligibility is a direct reflection of the growing body of research showing that lung screening saves lives,” Dr. Kim Sandler, assistant professor of Radiology and Radiological Sciences and co-director of the Vanderbilt Lung Screening Program, tells SurvivorNet. “It is imperative that we continue to raise awareness for lung cancer screening and these new eligibility guidelines so that we can detect lung cancer at its earliest stage when people can be cured."

The new recommendations were partially based on research that came out of Vanderbilt University Medical Center.

“Not only do we need to include more people (in screening), we need to find ways to increase participation to maximize the benefit to people,” Dr. Andrew Kaufman, who treats lung cancer patients at The Mount Sinai health system in New York, tells SurvivorNet.  “…Screening is probably the most important factor in increasing the numbers of people cured, while this is a great step forward, we remain committed to finding ways to include more and provide better access to these life saving tests.”

The new recommended guidelines specify that adults ages 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years should qualify for the screening. (One pack-year is the equivalent of smoking an average of 20 cigarettes, or one pack, per day for a year.)

Previous guidance from the USPSTF released in 2013 recommended annual screening for lung cancer in adults aged 55-80 who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.

Lung cancer is the second most common form of cancer, and the leading cause of cancer deaths in both men and women in the United States. In 2020, an estimated 228, 820 people were diagnosed with lung cancer, and 135, 720 people died.

According to the USPSTF statement published in the Journal of the American Medical Association (JAMA): “The most important risk factor for lung cancer is smoking. Increasing age is also a risk factor for lung cancer. Lung cancer has a generally poor prognosis, with an overall 5-year survival rate of 20.5%. However, early-stage lung cancer has a better prognosis and is more amenable to treatment.” The USPSTF is made up of 16 volunteer physicians who are nationally recognized experts in prevention, evidence-based medicine, and primary care.

Under the Affordable Care Act, recommendations from the USPSTF that receive and "A" or "B" rating should be covered by private insurers without cost. This recommendation received a "B".

The USPSTF says that expanding who is eligible for screening will be “especially helpful” to Black people and women and will increase access to screening. Data shows that both groups tend to smoke fewer cigarettes than white men. Data also shows that Black people have a higher risk of lung cancer than white people.

Lung Cancer Overview

There are two main types of lung cancer, which doctors group together based on how they act and how they're treated:

• Non-small cell lung cancer (NSCLC) is the most common type and makes up about 85% of cases
• Small cell lung cancer (SCLC) is less common, but it tends to grow faster than NSCLC and is treated very differently

While this is a serious cancer, its outlook is improving. For one thing, fewer people are getting lung cancer because smoking rates are on the decline.  Also, there have been improvements in surgical techniques and radiation delivery that have improved outcomes and decreased side effects. Finally, newer treatments like immunotherapy and targeted agents are dramatically improving the length and quality of life for people who are diagnosed with lung cancer.

Take it From a Guy Who Looks at Diseased Lungs Every Day Stop Smoking

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