The American College of Chest Physicians has published a new clinical guideline on screening for lung cancer. The key recommendation is:
For smokers and former smokers who are age 55 to 74 and who have smoked for 30 pack-years* or more and either continue to smoke or have quit within the past 15 years, we suggest that annual screening with low dose computed tomography [CT scan] should be offered… but only in settings that can deliver the comprehensive care provided to NLST [National Lung Screening Trial] participants.
My take: Reasonable advice, with reasonable cautions: 1) the NLST is the only randomized trial that has shown a mortality benefit (so only get screened if you meet the criteria for that trial (please see above); 2) there is the problem of false positives – CT scans can identify abnormalities that generate additional tests and procedures among those without lung cancer; and 3) screening should only be done in centers where there is expert multidisciplinary management and follow-up.
I’m Dr. Michael Hunter.