Practice Guidelines

Lung Cancer Screening Recommendations from the ACCP

 

Key Points for Practice

• Low-dose CT is recommended annually for asymptomatic adults 55 to 77 years of age who have smoked at least 30 pack years, and who continue to smoke or have quit within the past 15 years.

• Low-dose CT screening is not recommended in patients who do not meet the age and smoking criteria, even if they are considered high risk by clinical risk prediction calculators.

• Evidence-based tobacco cessation treatments should be provided to current smokers undergoing low-dose CT screening for lung cancer.

From the AFP Editors

Low-dose chest computed tomography (CT)-based screening for lung cancer has become the standard of care in the United States since the results of the National Lung Screening Trial were published. However, the benefits and harms of CT-based screening differ among patient populations, and it can be difficult to determine who should undergo screening. The American College of Chest Physicians (ACCP) recently published recommendations for lung cancer screening based on the following key questions developed using the PICO (population, intervention, comparator, and outcome) format:

  • What is the rate of death from lung cancer in persons at elevated risk who undergo screening with low-dose CT, compared with no screening or screening with another modality?

  • What is the rate of death from lung cancer in persons at elevated risk with different clinical phenotypes (sex, age, race, risk, chronic obstructive pulmonary disease, other comorbidities) who undergo screening with low-dose CT, compared with no screening or screening with another modality?

  • What is the rate of death or complications resulting from biopsies of screen-detected lesions among persons at elevated risk of lung cancer who undergo screening with low-dose CT, compared with no screening or screening with another modality?

  • What is the rate of death or complications resulting from biopsies of screen-detected lesions among persons at elevated risk of lung cancer with different clinical phenotypes (sex, age, race, risk, chronic obstructive pulmonary disease, other comorbidities) who undergo screening with low-dose CT, compared with no screening or screening with another modality?

  • What is the rate of surgery for benign disease among persons at elevated risk of lung cancer who undergo screening with low-dose CT, compared with no screening or screening with another modality?

  • What is the psychosocial impact (including distress, anxiety, depression, and quality of

Author disclosure: No relevant financial affiliations.

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.

A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.

 

 

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