Proposed New Lung Cancer Screening Guidelines
- The U.S. Preventive Services Task Force has proposed changing guidelines to make more people eligible for lung cancer screenings
- The guidelines would lower the age of eligibility and “pack history” (amount they’ve smoked over their lifetime) needed to be screened
- A leading expert says that these proposed guidelines would benefit patients — particularly women and minority groups who are at higher risk of fatal outcomes from lung cancer
Lung cancer currently stands as the leading cause of death for men and women in America, but a new set of guidelines proposed by the U.S. Preventive Services Task Force (USPSTF) may make screening more accessible to younger generations and Black communities who are especially affected by the disease.
“These proposed guidelines have the potential to be extremely beneficial to patients,” Dr. Brendon Stiles, a thoracic surgeon at Weill Cornell Medical Center, tells SurvivorNet. “The proposed strategy of starting screening at a younger age and lowering the smoking history threshold for eligibility is estimated to make lung cancer screening available to an additional 6.5% to 9.5% of patients. This would potentially prevent an additional 88-177 lung cancer deaths per 100,000 patients. Of course to benefit society on the whole, lung cancer screening needs to be performed carefully.”
In these drafted guidelines, the organization proposes that age eligibility for lung cancer screening should be lowered from 55 years old to 50 years old. Additionally, new guidelines in “pack years” would be changed — which is the number of years a person smoked an average of one pack of cigarettes a day. For example, if someone smoked one pack of cigarettes for 25 years their “pack history” would be 25 years; if someone smoked two packs of cigarettes a day for 25 years their “pack history” would be 50 years.
Related: Smart Tips For Getting Cancer Screenings Right Now From The Chief Medical Officer of the American Cancer Society
At the moment, the number of “pack years” which qualifies someone to be screened is 30, and under the new proposed guidelines, that would be lowered to 20. So, under these draft guidelines, a smoker who is 50 years old and has 20 year “pack history” could qualify for lung cancer screening.
The goal of these recommended guidelines is to make lung cancer screening more accessible to younger people — particularly women and the Black community — and encourage more people to be screened. This could be extremely important, as a study from the International Journal of Cancer found that lung cancer rates are now rising among younger women between the ages of 30 to 64 worldwide, and Black communities are more likely to have lung diseases.
“The USPSTF has increasingly recognized that the risk of developing lung cancer is different for individuals based upon race or gender,” says Dr. Stiles. “In particular, women, Blacks, and other minorities might be at equal or increased risk of developing lung cancer despite less tobacco smoke exposure. For example, Blacks have been estimated to have an average 1.4-fold increased risk of developing lung cancer compared to whites, despite smoking less on average. The recommendation to lower the screening threshold to 20 pack years and to decrease the minimum age of screening to 50 years old will make screening proportionately more available to at-risk women and minorities.”
Dr. Ronald Natale explains the difference of lung cancer in smokers vs. non-smokers
Quitting Smoking Can Decrease Lung Cancer Risk
Smoking is the leading cause of lung cancer in the United States, as 80% of lung cancer deaths are caused by smoking. This is due to the tobacco in cigarettes being a carcinogen that causes mutations in lung cells and enables the growth of cancer. Even if you’re not a smoker, exposure to secondhand smoke can also lead to a lung cancer diagnosis. However, thanks to more research and advancements in treatment options, it’s possible for past smokers to cut their risk of lung cancer if they stop smoking.
Related: FDA Orders The Most Significant Change To Cigarette Labels in 35 Years
“Smoking causes lung cancer,” says Dr. Joseph Friedberg, the head of the Division of Thoracic Surgery at the University of Maryland School of Medicine. “You know, that’s it. If you’re smoking, don’t smoke. You never return down all the way to the person who never smoked as far as your risk of lung cancer, but it goes down. It goes down with time. So if you’re smoking, stop. And that decreases your chance of getting a lung cancer.”
In addition to cutting your risk of a lung cancer diagnosis, quitting smoking also helps lung cancer patients have better outcomes in surgery. Smoking can cause small, hair-like cells called cilia that lines our windpipes to become paralyzed, which prevents mucus from effectively being cleared from the lungs. During surgery, the cilia secretions caught in the lungs may increase the risk of developing pneumonia.
Dr. Joseph Friedberg explains how quitting smoking can decrease lung cancer risks
The Immunotherapy Revolution In Lung Cancer
Deaths in lung cancer have dropped significantly over the years, and experts say that a huge reason is because of immunotherapy — a treatment method which harnesses the power of a person’s own immune system to recognize and kill cancer cells. Initially, immunotherapy was used for the treatment of advanced cancers, but researchers are continuing to learn how to treat early stage disease with this method either after surgery or chemotherapy, or whether they should be combined.
Related: How to Stop Coronavirus From Killing So Many African Americans? Address Poverty, Smoking, and Obesity, Says Leading Expert
“It’s not just hype,” says Dr. Stiles in a separate interview. “Immunotherapy is here to stay. It’s really changed the face of lung cancer, just like targeted therapies. It’s amazing to me now that you can have Stage IV lung cancer and actually not even need chemotherapy. If you have high expression of a protein that we know is targeted by immunotherapy, you may just get immunotherapy alone. That’s really changed the paradigm in lung cancer, and it’s a real thing. Response rates [are] upwards of 50%. So, much better than chemotherapy.”
While developments in immunotherapy, targeted therapies, chemotherapy, and radiation have improved the overall survival rate for lung cancer patients, it’s important to note that regular lung cancer screenings are critical in catching the disease early. The earlier a diagnosis is caught, the more treatment options are available.
Dr. Brendon Stiles says immunotherapy has changed the face of lung cancer treatment
Learn more about SurvivorNet's rigorous medical review process.
Proposed New Lung Cancer Screening Guidelines
- The U.S. Preventive Services Task Force has proposed changing guidelines to make more people eligible for lung cancer screenings
- The guidelines would lower the age of eligibility and “pack history” (amount they’ve smoked over their lifetime) needed to be screened
- A leading expert says that these proposed guidelines would benefit patients — particularly women and minority groups who are at higher risk of fatal outcomes from lung cancer
Lung cancer currently stands as the leading cause of death for men and women in America, but a new set of guidelines proposed by the U.S. Preventive Services Task Force (USPSTF) may make screening more accessible to younger generations and Black communities who are especially affected by the disease.
“These proposed guidelines have the potential to be extremely beneficial to patients,” Dr. Brendon Stiles, a thoracic surgeon at Weill Cornell Medical Center, tells SurvivorNet. “The proposed strategy of starting screening at a younger age and lowering the smoking history threshold for eligibility is estimated to make lung cancer screening available to an additional 6.5% to 9.5% of patients. This would potentially prevent an additional 88-177 lung cancer deaths per 100,000 patients. Of course to benefit society on the whole, lung cancer screening needs to be performed carefully.”
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In these drafted guidelines, the organization proposes that age eligibility for lung cancer screening should be lowered from 55 years old to 50 years old. Additionally, new guidelines in “pack years” would be changed — which is the number of years a person smoked an average of one pack of cigarettes a day. For example, if someone smoked one pack of cigarettes for 25 years their “pack history” would be 25 years; if someone smoked two packs of cigarettes a day for 25 years their “pack history” would be 50 years.
Related: Smart Tips For Getting Cancer Screenings Right Now From The Chief Medical Officer of the American Cancer Society
At the moment, the number of “pack years” which qualifies someone to be screened is 30, and under the new proposed guidelines, that would be lowered to 20. So, under these draft guidelines, a smoker who is 50 years old and has 20 year “pack history” could qualify for lung cancer screening.
The goal of these recommended guidelines is to make lung cancer screening more accessible to younger people — particularly women and the Black community — and encourage more people to be screened. This could be extremely important, as a study from the International Journal of Cancer found that lung cancer rates are now rising among younger women between the ages of 30 to 64 worldwide, and Black communities are more likely to have lung diseases.
“The USPSTF has increasingly recognized that the risk of developing lung cancer is different for individuals based upon race or gender,” says Dr. Stiles. “In particular, women, Blacks, and other minorities might be at equal or increased risk of developing lung cancer despite less tobacco smoke exposure. For example, Blacks have been estimated to have an average 1.4-fold increased risk of developing lung cancer compared to whites, despite smoking less on average. The recommendation to lower the screening threshold to 20 pack years and to decrease the minimum age of screening to 50 years old will make screening proportionately more available to at-risk women and minorities.”
Dr. Ronald Natale explains the difference of lung cancer in smokers vs. non-smokers
Quitting Smoking Can Decrease Lung Cancer Risk
Smoking is the leading cause of lung cancer in the United States, as 80% of lung cancer deaths are caused by smoking. This is due to the tobacco in cigarettes being a carcinogen that causes mutations in lung cells and enables the growth of cancer. Even if you’re not a smoker, exposure to secondhand smoke can also lead to a lung cancer diagnosis. However, thanks to more research and advancements in treatment options, it’s possible for past smokers to cut their risk of lung cancer if they stop smoking.
Related: FDA Orders The Most Significant Change To Cigarette Labels in 35 Years
“Smoking causes lung cancer,” says Dr. Joseph Friedberg, the head of the Division of Thoracic Surgery at the University of Maryland School of Medicine. “You know, that’s it. If you’re smoking, don’t smoke. You never return down all the way to the person who never smoked as far as your risk of lung cancer, but it goes down. It goes down with time. So if you’re smoking, stop. And that decreases your chance of getting a lung cancer.”
In addition to cutting your risk of a lung cancer diagnosis, quitting smoking also helps lung cancer patients have better outcomes in surgery. Smoking can cause small, hair-like cells called cilia that lines our windpipes to become paralyzed, which prevents mucus from effectively being cleared from the lungs. During surgery, the cilia secretions caught in the lungs may increase the risk of developing pneumonia.
Dr. Joseph Friedberg explains how quitting smoking can decrease lung cancer risks
The Immunotherapy Revolution In Lung Cancer
Deaths in lung cancer have dropped significantly over the years, and experts say that a huge reason is because of immunotherapy — a treatment method which harnesses the power of a person’s own immune system to recognize and kill cancer cells. Initially, immunotherapy was used for the treatment of advanced cancers, but researchers are continuing to learn how to treat early stage disease with this method either after surgery or chemotherapy, or whether they should be combined.
Related: How to Stop Coronavirus From Killing So Many African Americans? Address Poverty, Smoking, and Obesity, Says Leading Expert
“It’s not just hype,” says Dr. Stiles in a separate interview. “Immunotherapy is here to stay. It’s really changed the face of lung cancer, just like targeted therapies. It’s amazing to me now that you can have Stage IV lung cancer and actually not even need chemotherapy. If you have high expression of a protein that we know is targeted by immunotherapy, you may just get immunotherapy alone. That’s really changed the paradigm in lung cancer, and it’s a real thing. Response rates [are] upwards of 50%. So, much better than chemotherapy.”
While developments in immunotherapy, targeted therapies, chemotherapy, and radiation have improved the overall survival rate for lung cancer patients, it’s important to note that regular lung cancer screenings are critical in catching the disease early. The earlier a diagnosis is caught, the more treatment options are available.
Dr. Brendon Stiles says immunotherapy has changed the face of lung cancer treatment
Learn more about SurvivorNet's rigorous medical review process.
