The United States Preventive Services Task Force updated its 2013 lung cancer screening guidelines in March 2021 to expand the population that should be screened. The recommendation for low dose chest CT screening now includes adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
Rationale:
- Relative to the 2013 USPSTF screening program of patients aged 55-80 with 30 year pack-year history, modeling analysis of the new recommended screening guidelines suggest lung cancer mortality would be reduced by 13.0% vs 9.8%.
- The new guidelines also help decrease racial and gender disparities. Studies have shown Black persons, LatinX persons, and women tend to smoke at lower intensities than White men, and are less often screened per the 2013 guidelines. The new guidelines will increase inclusion of these populations in lung cancer screening.
Who is affected?
- Adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years
How to implement?
- low dose CT every year for screening of lung cancer
Important considerations
- USPSTF changes apply to commercial insurance plans covered by Affordable Care Act. These plans aren’t required to provide the expanded benefit until January of 2023, so it’s important to remind patients to check their benefits before scheduling.
- Centers for Medicare & Medicaid Services criteria for lung cancer screening have not changed (still follow 2013 guidelines of adults aged 55-80 with history of 30 pack years or more of smoking and who have quit in the last 15 years or are currently smoking)
References:
US Preventive Services Task Force, Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, Davis EM, Donahue KE, Doubeni CA, Kubik M, Landefeld CS, Li L, Ogedegbe G, Owens DK, Pbert L, Silverstein M, Stevermer J, Tseng CW, Wong JB. Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021 Mar 9;325(10):962-970. doi: 10.1001/jama.2021.1117. PMID: 33687470.
written by Daina Ringus