Contemporary Implications of U.S. Preventive Services Task Force and Risk-Based Guidelines for Lung Cancer Screening Eligibility in the United States
Authors: Rebecca Landy, Li C. Cheung, Christine D. Berg, Anil K. Chaturvedi, Hilary A. Robbins, Hormuzd A. Katki
Journal: Annals of Internal Medicine (2019)

Letters3 September 2019Contemporary Implications of U.S. Preventive Services Task Force and Risk-Based Guidelines for Lung Cancer Screening Eligibility in the United StatesRebecca Landy, PhD, Li C. Cheung, PhD, Christine D. Berg, MD, Anil K. Chaturvedi, PhD, Hilary A. Robbins, PhD, and Hormuzd A. Katki, PhDRebecca Landy, PhDNational Cancer Institute, National Institutes of Health, Bethesda, Maryland (R.L., L.C.C., C.D.B., A.K.C., H.A.K.), Li C. Cheung, PhDNational Cancer Institute, National Institutes of Health, Bethesda, Maryland (R.L., L.C.C., C.D.B., A.K.C., H.A.K.), Christine D. Berg, MDNational Cancer Institute, National Institutes of Health, Bethesda, Maryland (R.L., L.C.C., C.D.B., A.K.C., H.A.K.), Anil K. Chaturvedi, PhDNational Cancer Institute, National Institutes of Health, Bethesda, Maryland (R.L., L.C.C., C.D.B., A.K.C., H.A.K.), Hilary A. Robbins, PhDInternational Agency for Research on Cancer, Lyon, France (H.A.R.), and Hormuzd A. Katki, PhDNational Cancer Institute, National Institutes of Health, Bethesda, Maryland (R.L., L.C.C., C.D.B., A.K.C., H.A.K.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3617 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: U.S. Preventive Services Task Force (USPSTF) lung cancer screening guidelines recommend annual computed tomography (CT) screening for current or former smokers ("ever-smokers") aged 55 to 80 years with 30 or more pack-years of smoking and no more than 15 years since quitting (1). These criteria aim to improve the balance of benefits and harms of CT screening. However, using risk models to select ever-smokers for screening may be more effective and efficient (2). The USPSTF is considering recommending use of externally validated models (3) for screening. Although lung cancer risk models have been validated (4), their risk thresholds are ...References1. Moyer VA; U.S. Preventive Services Task Force. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160:330-8. [PMID: 24378917]. doi:10.7326/M13-2771 LinkGoogle Scholar2. Katki HA, Kovalchik SA, Berg CD, Cheung LC, Chaturvedi AK. Development and validation of risk models to select ever-smokers for CT lung cancer screening. JAMA. 2016;315:2300-11. [PMID: 27179989] doi:10.1001/jama.2016.6255 CrossrefMedlineGoogle Scholar3. U.S. Preventive Services Task Force. Draft Research Plan: Lung Cancer: Screening. Rockville, MD: U.S. Preventive Services Task Force; 2018. Accessed at www.uspreventiveservicestaskforce.org/Page/Document/draft-research-plan/lung-cancer-screening1 on 25 February 2019. Google Scholar4. Katki HA, Kovalchik SA, Petito LC, Cheung LC, Jacobs E, Jemal A, et al. Implications of nine risk prediction models for selecting ever-smokers for computed tomography lung cancer screening. Ann Intern Med. 2018;169:10-9. [PMID: 29800127]. doi:10.7326/M17-2701 LinkGoogle Scholar5. Tammemägi MC, Church TR, Hocking WG, Silvestri GA, Kvale PA, Riley TL, et al. Evaluation of the lung cancer risks at which to screen ever- and never-smokers: screening rules applied to the PLCO and NLST cohorts. PLoS Med. 2014;11:e1001764. [PMID: 25460915] doi:10.1371/journal.pmed.1001764 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Cancer Institute, National Institutes of Health, Bethesda, Maryland (R.L., L.C.C., C.D.B., A.K.C., H.A.K.)International Agency for Research on Cancer, Lyon, France (H.A.R.)Note: The Lung Cancer Death Risk Assessment Too was previously proposed in a manuscript coauthored by Drs. Cheung, Berg, Chaturvedi, and Katki.Disclaimer: The National Institutes of Health had no role in the design and conduct of the study; the collection, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript. The authors are solely responsible for the views expressed in this article, which do not necessarily represent the views, decisions, or policies of the institutions with which the authors are affiliated.Acknowledgment: The authors thank the reviewers, whose comments greatly improved the manuscript.Financial Support: By the Intramural Research Program of the National Cancer Institute, National Institutes of Health.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3617.Reproducible Research Statement: Study protocol: Not available. Statistical code and data set: Available from Dr. Landy (e-mail, rebecca.[email protected]gov).This article was published at Annals.org on 4 June 2019. 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