The U.S. Preventive Services Task Force has recently changed the guidelines for lung cancer screening. Listen to two experts who helped establish the first set of screening guidelines. Then hear from a patient advocate living with lung cancer on how the change in screening is a step in the right direction.
Dr. Denise Aberle, LCFA Scientific Advisory Board
David Sturges, LCFA Co-founder and lung cancer survivor
Terri Conneran, LCFA Speaker Bureau member
Download Show Notes | Transcription
Establishing the first set of NLST guidelines
The first NCI-sponsored National Lung Screening Trial (NLST) was a trial to compare two ways of lung cancer screening: low dose helical CT versus chest radiography. The NLST was the joint collaboration of ACRIN and the Lung Screening Study.
Dr. Denise Aberle served as the national Principal Investigator of the American College of Radiology Imaging Network (ACRIN-NLST) component of the National Lung Screening Trial. Dr. Aberle’s research also centers on lung cancer and oncologic imaging for response assessment, quantitative image analysis, and oncology informatics.
LCFA’s co-founder, David Sturges served on the United States Department of Defense’s Congressionally Directed Medical Research Programs’ Integration Panel. He was the sole patient advocate at the table for the groundbreaking NLST’s Data and Safety Monitoring Board (DSMB).
Who should be screened for lung cancer?
These new lung cancer screening guidelines have two significant changes to the previous criteria in place regarding who qualifies for annually testing:
- Lowered the age from 55 to 50 so now the Age Range criteria is now Ages 50 – 77.
- Changed the Pack Years of Smoking calculation from using 30 pack years of smoking to using 20 pack years of smoking.
Although these improved guidelines may lead to more smokers getting tested for lung cancer earlier, there are many factors that might put you at risk for lung cancer. Many people believe that smoking alone causes lung cancer.
But, increasingly, people who have never smoked or who quit smoking many years ago are being diagnosed with lung cancer. Hear from Terri Conneran, member of LCFA’s Speakers Bureau, tell her diagnosis story as one who didn’t meet these criteria. Learn more about her road to her specific diagnosis, which did not follow a direct route.
Why is the change in screening guidelines important?
Besides the statistic that more than half of new lung cancer patients have never smoked or quit more than 15 years ago are not included in the original CT screening recommendations:
- These revisions will reduce both racial and sex disparities to enable screening in a higher risk groups and additional percentage of the population who we know are going to get lung cancer.
- They will provide greater benefits in reducing lung cancer mortality across the United States.
What effect will the change in screening guidelines have for people who are diagnosed with lung cancer?
Currently, only 19 out of 100 people who qualify under the original guidelines get screened. The newly updated lung cancer screening guidelines will lead to many more people getting screened. When diagnosed earlier, healthcare teams are helping them live longer healthier lives with the right treatment.
The importance of early diagnosis of lung cancer
When detected early, lung cancer patients have more treatment options and a far greater chance of survival. The 5-year survival rate for those diagnosed before the cancer has spread rises from 18 out of every 100 people to 55 out of every 100. But, the key is being screened for lung cancer early.
“The trial lasted from 2002 when we launched to about 2010, and was able over time to identify that low dose CT screening did in fact reduce deaths from lung cancer because of early detection. The name of the game is early detection because that’s when the cancer can be treated and is most likely to be curable, meaning to result in long-term survival. And that’s exactly what we saw.” Dr. Denise Aberle
And, even with the new lung cancer screening guidelines, there still is an emphasis on screening people who are either current or former smokers. These guidelines still won’t catch many of the lung cancers in never smoking patients who have a genetic alteration driving their cancer.
“While we were talking about smoking and pack-years and all of that, it’s true that if you have lungs, you can get lung cancer, right? I mean, you just have to be on top of your health as much as you possibly can. Every breath counts, for sure.”