Research News

Lung Cancer Screening

March 30, 2021

U.S. Preventive Services Task Force

Summary

Detection

Latest in depth analysis and recommendations for lung cancer screening from the United States Preventive Services Task Force

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Recommendation Summary

Population Recommendation
Adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or quit within the past 15 years The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.
Grade: B

Clinician Summary

What does the USPSTF recommend?

Adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years: Screen for lung cancer with low-dose computed tomography (CT) every year. Stop screening once a person has not smoked for 15 years or has a health problem that limits life expectancy or the ability to have lung surgery. Grade: B

To whom does this recommendation apply?

Adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. (See below for definition of pack-year.)

What’s New?

The USPSTF has revised the recommended ages and pack-years for lung cancer screening. It expanded the age range to 50 to 80 years (previously 55 to 80 years), and reduced the pack-year history to 20 pack-years of smoking (previously 30 pack-years).

How to implement this recommendation?

Assess risk based on age and pack-year smoking history: Is the person aged 50 to 80 years and have they accumulated 20 pack-years or more of smoking? A pack-year is a way of calculating how much a person has smoked in their lifetime. One pack-year is the equivalent of smoking an average of 20 cigarettes—1 pack—per day for a year.  Screen: If the person is aged 50 to 80 years and has a 20 pack-year or more smoking history, engage in shared decision-making about screening. The decision to undertake screening should involve a discussion of its potential benefits, limitations, and harms. If a person decides to be screened, refer them for lung cancer screening with low-dose CT, ideally to a center with experience and expertise in lung cancer screening. If the person currently smokes, they should receive smoking cessation interventions.

How often?

Screen every year with low-dose CT. Stop screening once a person has not smoked for 15 years or has a health problem that limits life expectancy or the ability to have lung surgery.

What are other relevant USPSTF recommendations?

The USPSTF has made recommendations on interventions to prevent the initiation of tobacco use in children and adolescents, and on behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women. These recommendations are available at USPSTF.

Where to read the full recommendation statement?

Visit the USPSTF Web site to read the full recommendation statement. This includes more details on the rationale of the recommendation, including benefits and harms; supporting evidence; and recommendations of others.

The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation.

Additional Information