CT screening for high-risk smokers

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Lung cancer kills nearly 160,000 people each year, more than breast, colon, prostate and pancreatic cancers combined. And by the time most lung cancers are diagnosed, they have metastasized and cannot be treated. Now the American College of Chest Physicians has issued new guidelines stating that doctors should consider low-dose CT screening for individuals at high risk for lung cancer, defined as current smokers ages 55 to 74 with more than 30 pack-years of smoking, or past smokers with that same profile but who have quit in the last 15 years. A pack-year is defined as smoking 20 cigarettes a day for a year, or its equivalent.

This recommendation is less comprehensive than a previous recommendation issued by the National Comprehensive Cancer Network, which says that people ages 50 and older who have 20 pack-years of smoking in addition to other risk factors such as having a close relative with lung cancer, should be screened.

However, there are some drawbacks with these recommendations. One concern is that physicians will begin to offer the test for free. In an effort to make up for lost costs of free screening, doctors may be more inclined to push for further screening if abnormalities are found, even though 97 percent of those abnormalities do not end up being serious. But, when thinking about screening for lung cancer as opposed to breast cancer, the National Lung Screening Test the study upon which these recommendations were based found that in order to save one person from dying from lung cancer, 320 high-risk smokers would have to be screened. For mammograms, that number is 780.

ACSH s Dr. Elizabeth Whelan says, I do believe that if you are a high-risk smoker who meets these qualifications, screening is a good idea. Ultimately though, the best advice I would give someone is to quit smoking or don t start.