Non small cell lung cancer screening

Non Small Cell Lung Cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Non Small Cell Lung Cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-Ray

CT Scan

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Management Approach

Stage I
Stage II
Stage III
Stage IV
Metastatic Cancer

Medical Therapy

Chemotherapy
Radiation Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Non small cell lung cancer screening On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Non small cell lung cancer screening

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Non small cell lung cancer screening

CDC on Non small cell lung cancer screening

Non small cell lung cancer screening in the news

Blogs on Non small cell lung cancer screening

Directions to Hospitals Treating Non small cell carcinoma of the lung

Risk calculators and risk factors for Non small cell lung cancer screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2],Maria Fernanda Villarreal, M.D. [3]

## Overview[edit | edit source]

The U.S. Preventive Services Task Force (USPSTF) recommends annual screening for lung cancer by low-dose computed tomography. The screening test is recommended to the smokers who are between 55 to 80 years old and who have a history of smoking 30 pack-years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation).

## Screening[edit | edit source]

According to the U.S. Preventive Services Task Force (USPSTF), screening for lung cancer by low-dose computed tomography is recommended every year among smokers who are between 55 to 80 years old and who have history of smoke 30 pack-years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation).[1][2]

Guidelines

* According to the clinical practice guideline by the U.S. Preventive Services Task Force (USPSTF), screening for lung cancer by low-dose computed tomography (LDCT) is recommended every year among smokers and former smokers who are between 55 to 80 years old and who have smoked 30 pack-years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation).[3]

* According to the clinical practice guideline issued by the American College of Chest Physicians (CHEST) in 2013, screening for lung cancer by low-dose CT (LDCT) is recommended every year among smokers and former smokers who are age 55 to 74 and who have smoked for 30 pack-years or more and either continue to smoke or have quit within the past 15 years.[4]

Strategies

* Low-dose helical computed tomography:[5]
* Pros:
* There is evidence that screening persons aged 55 to 74 years who have cigarette smoking histories of 30 or more pack-years and who, if they are former smokers, have quit within the last 15 years reduce lung cancer mortality by 20% and all-cause mortality by 6.7%.
* Cons:
* The majority of all positive low-dose helical computed tomography screening exams do not result in a lung cancer diagnosis. False-positive exams may result in unnecessary invasive diagnostic procedures.

* Chest x-ray and/or sputum cytology:[6]
* Pros:
* Screening with chest x-ray and/or sputum cytology does not reduce mortality from lung cancer in the general population or in ever-smokers.
* Cons:
* False positive exams
* The majority of all positive chest x-ray screening exams do not result in a lung cancer diagnosis.
* False-positive exams result in unnecessary invasive diagnostic procedures.

Overdiagnosis

* Based on current evidence, the majority of non-small cell lung cancers detected by screening chest x-ray and/or sputum cytology appear to represent overdiagnosed cancer.[6]
* The magnitude of overdiagnosis appears to be between 5% and 25%.
* These cancers result in unnecessary diagnostic procedures and also lead to unnecessary treatment.
* Harms of diagnostic procedures and treatment occur most frequently among long-term and/or heavy smokers because of smoking-associated comorbidities that increase risk propagation.

## Screening Guidelines[edit | edit source]

* The table below summarizes the screening eligibility for non-small cell lung cancer screening by different organizations.

Screening Guidelines for Non Small Cell Lung Cancer
Adapted from Center of Disease Control and Prevention (CDC). 2016 [7] |

|

Organization | Groups eligible for screening | Year
American Academy of Family Practice  | Evidence is insufficient to recommend for or against screening  | 2013
American Association of Thoracic Surgery  |

1\. Age 55 to 79 years with 30 pack year smoking history

2\. Long term lung cancer survivors who have completed 4 years of surveillance without recurrence and who can tolerate lung cancer treatment following screening to detect second primary lung cancer until the age of 79

3\. Age 50 to 79 years with a 20 pack year smoking history and additional comorbidity that produces a cumulative risk of developing lung cancer ≥ 5% in 5 years

2012

American Cancer Society  |

Age 55 to 74 years with ≥30 pack year smoking history, who either currently smoke or have quit within the past 15 years, and who are in relatively good health

2015

American College of Chest Physicans  |

Age 55 to 74 years with ≥30 pack year smoking history,who either currently smoke or have quit within the past 15 years

2013

American Society of Clinical Oncology  |

Age 55 to 74 years with ≥30 pack year smoking history,who either currently smoke or have quit within the past 15 years

2012

American Lung Association  |

Age 55 to 74 years with ≥ 30 pack year smoking history and no history of lung cancer

2012

Medicaid Services  |

Age 55 to 77 years with ≥ 30 pack year smoking history and smoking cessation < 15 years

2015

National Comprehensive Cancer Network  |

Age 55 to 74 years with ≥30 packyear smoking history and smoking cessation < 15 years OR Age ≥ 50 years and ≥20 pack year smoking history and additional risk factor (other than secondhand smoke exposure

2015

U.S Preventive Services Task Force  |

Age 55 to 80 years with ≥30 pack year smoking history and smoking cessation < 15 years

2013

## References[edit | edit source]

1. ↑ Lung Cancer: Screening http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening. Accessed on February 3, 2016
2. ↑ Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.
3. ↑ Lung Cancer Screening. U.S. Preventive Services Task Force 2015. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening Accessed on December 20, 2015
4. ↑ Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB (2013). "Screening for Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 143 (5 Suppl): e78S–92S. doi:10.1378/chest.12-2350. PMID 23649455.CS1 maint: Multiple names: authors list (link)  Summary in JournalWatch
5. ↑ Lung Cancer Screening. National Cancer Institute 2015. http://www.cancer.gov/types/lung/hp/lung-screening-pdq Accessed on December 20, 2015
6. ↑ 6.0 6.1 Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.
7. ↑ Screening for non-small cell lung cancer. http://www.cdc.gov/cancer/lung/pdf/guidelines.pdf Accessed on February 22, 2016

Template:WikiDoc Sources