Updated ACS Guidelines Recommend Screening More Patients for Lung Cancer

The American Cancer Society (ACS) has updated its guidelines for lung cancer screening to expand the population of patients who should be screened.¹

The guidelines now recommend annual lung cancer screening with low‐dose computed tomography (CT) for asymptomatic patients aged 50 to 80 years who are current or former smokers and have at least a 20 pack‐year smoking history.

For former smokers, the number of years since they quit smoking should not impact the decision to start or stop screening, the guidelines state.

The guidelines also recommend that, before screening, patients should receive evidence‐based counseling for smoking cessation and be offered interventions if they currently smoke. Health care professionals should engage patients in shared decision‐making discussions about the potential benefits, harms, and limitations of lung cancer screening.

The guidelines note that patients should not undergo lung cancer screening if they have health conditions that “may increase harm or hinder further evaluation, surgery, or treatment for lung cancer,” if they have comorbidities that limit their life expectancy to less than 5 years, or if they are unwilling to accept treatment for cancer detected via screening.

The prior ACS guidelines, released in 2013, recommended annual lung cancer screening with low-dose CT in current or former smokers who were 55 to 74 years of age, had quit smoking in the past 15 years, and had at least a 30 pack-year smoking history.² Screening was not recommended for patients with life-limiting comorbidities, those with metallic implants or devices in their chest or back, or patients who required home oxygen supplementation.

“This updated guideline continues a trend of expanding eligibility for lung cancer screening in a way that will result in many more deaths prevented,” guideline author Robert Smith, PhD, senior vice president of early cancer detection science at ACS, said in a statement.³

“Recent studies have shown extending the screening age for persons who smoke and formerly smoked, eliminating the ‘years since quitting’ requirement, and lowering the pack per year recommendation could make a real difference in saving lives,” he added.

Disclosures: Some guideline authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the first reference for a full list of disclosures.

References

1. Wolf AMD, Oeffinger KC, Shih TY‐C, et al. Screening for lung cancer: 2023 guideline update from the American Cancer Society. CA Cancer J Clin. Published online November 1, 2023. doi:10.3322/caac.21811

2. Wender R, Fontham ETH, Barrera E Jr, et al. American Cancer Society lung cancer screening guidelines. CA Cancer J Clin. 2013;63(2):107‐117. doi:10.3322/caac.21172

3. American Cancer Society updates lung cancer screening guideline: Nearly five million US adults who smoke and formerly smoked now recommended for testing. News Release. American Cancer Society. Published November 1, 2023. Accessed November 1, 2023.

This article originally appeared on Cancer Therapy Advisor