USPSTF expands CT lung cancer screening guidelines to include more high-risk individuals

The U.S. Preventative Services Task Force on Tuesday proposed expanding recommendations that would significantly increase the number of Americans eligible for CT lung cancer screening, including more African Americans and women.

In the new draft statement, USPSTF calls for lowering the starting age of annual low-dose CT screening for smokers—who have a 20-pack-year smoking history or who have quit within the last 15 years—from age 55 down to 50. Previously, the task force recommended screening in those with a 30-pack-year history.

The new guidelines will be particularly helpful for spotting cancer in African Americans and women. Both groups tend to smoke fewer cigarettes than white men, with data showing Black individuals face a higher risk of lung cancer than white people. 

“New evidence provides proof that there are real benefits to starting to screen at a younger age and among people with a lighter smoking history,” USPSTF member Michael J. Barry, MD, said in a statement. “We can not only save more lives, we can also help people stay healthy longer.”

The American College of Radiology came out in strong support of the changes, saying Tuesday that expanding LDCT screening to high-risk patients “significantly reduces lung cancer deaths.” And given the American Cancer Society estimates 135,720 lung cancer deaths will occur this year, the ACR believes such screening could save up to 60,000 lives annually.

In its statement statement, the ACR also suggested broadening the quit-smoking requirement from 15 to 20 years.

“It's great to see the draft USPSTF proposal extending the reach of this massive lifesaving benefit to more people at risk,” said Ella Kazerooni MD, chair of the ACR Lung-RADS committee and Lung Cancer Screening Registry. “The lower starting age and broader pack-year threshold will help save more lives from the nation’s leading cancer killer.”