USPSTF finalizes recommendation for low-dose CT lung screening

The U.S. Preventive Services Task Force (USPSTF) has given final approval for recommending annual low-dose CT (LDCT) screening for adults age 55-80 at a high risk for lung cancer.

The recommendation applies to individuals who have a 30 pack-year smoking history and remain smokers or have quit within the past 15 years. Screening can be discontinued once the individual has not smoked for 15 years or once health problems limit life expectancy and the willingness to undergo curative lung surgery.

“Although lung cancer screening is not an alternative to smoking cessation, the USPSTF found adequate evidence that annual screening for lung cancer with LDCT in a defined population of high-risk persons can prevent a substantial number of lung cancer–related deaths,” wrote USPSTF on its website. The highly publicized National Lung Cancer Screening Trial was described by the task force as offering the best evidence of the benefit of LDCT screening.

USPSTF designated the recommendation as grade B, which is given to services the task force believes to have a high certainty of moderate benefit or a moderate certainty of moderate to substantial benefit. Under the Affordable Care Act, Medicare and private insurers are required to provide coverage of procedures that receive a B grade or higher.

In a statement, the American College of Radiology (ACR) said expanded use of CT lung cancer screening in high-risk patients would be a landmark step in battling the disease.

“The College expects to complete development of CT Lung Cancer Screening Appropriateness Criteria and corresponding practice guidelines and standards in the coming months. This will help ensure safe, effective diagnostic care for those at high-risk for lung cancer,” said Paul Ellenbogen, MD, FACR, chair of the ACR Board of Chancellors, in the statement.

The ACR is also working on a lung image database and practice auditing system that will provide management recommendations similar to the BIRADS system used in mammography. “These materials will help ensure that those who should be screened can be tested regardless of where they live and provide for a robust screening program that can help save as many lives as possible,” said Ella A. Kazerooni, MD, chair of the ACR Thoracic Imaging Panel and Committee on Lung Cancer Screening.