Putting Prevention into Practice
An Evidence-Based Approach
Screening for Lung Cancer
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Am Fam Physician. 2014 Jul 15;90(2):117-118.
Related U.S. Preventive Services Task Force Recommendation Statement: Screening for Lung Cancer: Recommendation Statement
Related editorial: Should Family Physicians Routinely Screen for Lung Cancer in High-Risk Populations? Yes: CT-Based Screening Is Complex but Worthwhile
Related editorial: Should Family Physicians Routinely Screen for Lung Cancer in High-Risk Populations? No: The USPSTF's Recommendation for Lung Cancer Screening Is Overreaching
M.B., a woman with diabetes mellitus, presents to your office for an annual well visit. M.B. reports having smoked one and a half packs of cigarettes daily for 20 years. Her neighbor was recently diagnosed with lung cancer, and M.B. requests to be tested for lung cancer, too.
Case Study Questions
In which of the following situations would the U.S. Preventive Services Task Force (USPSTF) recommend that M.B. be screened for lung cancer?
A. M.B. is 60 years of age, her diabetes is well controlled by diet, and she quit smoking 20 years ago.
B. M.B. is 60 years of age, her diabetes is well controlled by medications, and she quit smoking 10 years ago.
C. M.B. is 75 years of age, her diabetes is well controlled by medications, and she currently smokes.
D. M.B. is 78 years of age, her diabetes is poorly controlled, she has emphysema and heart failure with an ejection fraction of 30%, and she currently smokes.
It is determined that M.B. should be screened for lung cancer. According to the USPSTF, which one of the following screening tests is recommended?
A. Annual chest radiography with sputum cytology.
B. Chest radiography and sputum cytology once every three years.
C. Annual low-dose computed tomography (CT).
D. Low-dose CT once every three years.
E. Annual magnetic resonance imaging.
Based on the USPSTF's findings, which one of the following statements about the potential benefits or harms of lung cancer screening is correct?
A. Annual screening
Author disclosure: No relevant financial affiliations.
U.S. Preventive Services Task Force. Screening for lung cancer. U.S. Preventive Services Task Force. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330–338.
Humphrey LL, Deffebach M, Pappas M, et al. Screening for lung cancer with low-dose computed tomography: a systematic review to update the U.S. Preventive Services Task Force recommendation. Ann Intern Med. 2013;159(6):411–420.
de Koning HJ, Meza R, Plevritis SK, et al. Benefits and harms of computed tomography lung cancer screening strategies: a comparative modeling study for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;160(5):311–320.
The case study and answers to the following questions are based on the recommendations of the U.S. Preventive Services Task Force (USPSTF), an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. More detailed information is available in the USPSTF Recommendation Statement, evidence report, and modeling study at http://www.uspreventiveservicestaskforce.org. The practice recommendations in this activity are available at http://www.uspreventiveservicestaskforce.org/uspstf/uspslung.htm.
Copyright © 2014 by the American Academy of Family Physicians.
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