More Smokers Should Be Scanned for Lung Cancer, Panel Says

WASHINGTON—A federal medical panel is calling for a significant expansion of CT scanning for smokers to detect lung cancer, citing studies that found the imaging studies can save more lives than previously known.

The U.S. Preventive Services Task Force is advising people ages 50 to 80 to get the screening if they have smoked on average a pack of cigarettes daily for 20 years, and who currently smoke or have quit within the past 15 years.

The panel’s previous recommendation, in 2013, recommended people get screened between ages 55 and 80, and have smoked the equivalent of a pack of cigarettes a day for 30 years, and currently smoke or have quit within the past 15 years.

The task force decision is based on accumulated evidence from 223 published studies, with the largest being the National Lung Screening Trial in the U.S., with over 53,000 people enrolled. Another more recent study in Europe with 15,792 generally younger participants showed a greater benefit in lives saved—and was largely responsible for the panel’s lowering the age range for recommended CT screening.

The panel is an independent group of medical specialists whose advice helps determine federal policy. The federal Medicare program has agreed with the recommendations, according to a panel member, and private insurers will be required to include free CT screening under the federal Affordable Care Act.

The task force estimates about 15 million Americans should get CT scanning under its updated recommendation, from about eight million previously.

CT is short for computed tomography, and like X-rays the scans do expose people to low doses of radiation. But doctors including Michael J. Barry, a panel member and medical professor at Harvard Medical School, believe the benefits of detecting lung cancer as early as possible outweigh the risks.

“The two largest trials we evaluated showed a 20% to 25% reduction in lung-cancer mortality,” said Dr. Barry. So far, he said, most smokers who qualify haven’t gotten screened.

“Utilization of the CT screening has been a real problem, with at best 15% of people under our prior recommendation” getting screened, he said. “It is still a new kid on the block, compared to Pap screening and colon-cancer screening.”

Dr. Barry added that smoking increases the risk of lung cancer twentyfold, and people shouldn’t smoke at all—but if they do, a CT scan can spot signs of trouble early on.

Lung cancer is the nation’s leading cause of cancer death, with an estimated 137,720 people dying of the disease in 2020. Also in 2020, an estimated 228,820 people were diagnosed with lung cancer in the U.S.

The task force recommends that people who meet their guidelines be screened every year with low-dose CT. The screenings, they advise, should continue until a person hasn’t smoked for 15 years or has a health problem limiting life expectancy or the ability to have lung surgery.

Write to Thomas M. Burton at

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Source: WSJ – US News

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