Squamous cell carcinoma of the lung screening
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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
According to the U.S. Preventive Services Task Force (USPSTF), screening for lung cancer by low-dose computed tomography (LDCT) 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).
Screening
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).[1][2][3][4]
- According to 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 aged between 55 and 74 years and who have smoked for 30 pack-years or more and either continue to smoke or have quit within the past 15 years.[5]
- To view all the screening guidelines recommendations for squamous cell lung carcinoma, click here
Strategies
- Low-dose helical computed tomography:[6]
- Benefits
- 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 reduces lung cancer mortality by 20% and all-cause mortality by 6.7%.
- Harms
- The majority of 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.
- Benefits
- Screening with chest x-ray and/or sputum cytology does not reduce mortality from lung cancer in the general population or in ever-smokers.
- Harms
- False positive exams
- The majority of all positive chest x-ray screening exams do not result in a true positive diagnosis of lung cancer.
- False-positive exams result in unnecessary invasive diagnostic procedures.
Over-diagnosis
- 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 over-diagnosed cancer.[8]
- The magnitude of over-diagnosis 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.
References
- ↑ 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
- ↑ Lung Cancer: Screening http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening. Accessed on February 3, 2016 <nowiki><nowiki>
- ↑ Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.
- ↑ National Lung Screening Trial.National_Lung_Screening_Trial Accessed on February 4,2016 https://www.cancer.gov/types/lung/research/nlst https://www.cancer.gov/types/lung/research/NLSTstudyGuidePatientsPhysicians.pdf
- ↑ 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. Summary in JournalWatch
- ↑ Lung Cancer Screening. National Cancer Institute 2015. http://www.cancer.gov/types/lung/hp/lung-screening-pdq Accessed on December 20, 2015
- ↑ Pinsky PF, Church TR, Izmirlian G, Kramer BS (November 2013). "The National Lung Screening Trial: results stratified by demographics, smoking history, and lung cancer histology". Cancer. 119 (22): 3976–83. doi:10.1002/cncr.28326. PMC 3936005. PMID 24037918.
- ↑ 8.0 8.1 Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.
- ↑ Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, Gareen IF, Gatsonis C, Marcus PM, Sicks JD (August 2011). "Reduced lung-cancer mortality with low-dose computed tomographic screening". N. Engl. J. Med. 365 (5): 395–409. doi:10.1056/NEJMoa1102873. PMC 4356534. PMID 21714641.