Non small cell lung cancer screening: Difference between revisions
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{{Non small cell lung cancer}} | {{Non small cell lung cancer}} | ||
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==Overview== | ==Overview== | ||
The [[USPSTF|U.S. Preventive Services Task Force (USPSTF)]] recommends annual screening for [[lung cancer]] by [[Computed tomography|low-dose computed tomography]]. The screening test is recommended to the [[Smoking|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== | |||
* [[ | According to the [[United states preventive services task force recommendations scheme|U.S. Preventive Services Task Force (USPSTF)]], screening for [[lung cancer]] by [[Computed tomography|low-dose computed tomography]] is recommended every year among smokers who are between 55 to 80 years old and who have history of [[Smoking|smoke]] 30 pack-years or more and either continue to [[Smoking|smoke]] or have quit within the past 15 years (grade B recommendation).<ref name="“lung">Lung Cancer: Screening http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening. Accessed on February 3, 2016 </ref><ref name="“JAMA”">Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.</ref> | ||
* | '''Guidelines''' | ||
* According to the clinical practice guideline by the [[United states preventive services task force recommendations scheme|U.S. Preventive Services Task Force (USPSTF)]], [[Screening test|screening]] for [[lung cancer]] by [[Computed tomography|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).<ref>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</ref> | |||
* According to the [[clinical practice guideline]] issued by the [[American College of Chest Physicians]] (CHEST) in 2013, [[Lung cancer screening|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.<ref name="pmid23649455">{{cite journal| author=Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB| title=Screening for Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2013 | volume= 143 | issue= 5 Suppl | pages= e78S-92S | pmid=23649455 | doi=10.1378/chest.12-2350 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23649455 }} [http://general-medicine.jwatch.org/cgi/content/full/2013/522/2 Summary in JournalWatch]</ref> | |||
'''Strategies''' | |||
*'''Low-dose helical computed tomography''':<ref name="lungscreen">Lung Cancer Screening. National Cancer Institute 2015. http://www.cancer.gov/types/lung/hp/lung-screening-pdq Accessed on December 20, 2015</ref> | |||
** 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 rate|mortality]] by 20% and all-cause [[Mortality rate|mortality]] by 6.7%. | |||
** Cons: | |||
***The majority of all positive [[Computed tomography|low-dose helical computed tomography]] [[Screening test|screening]] exams do not result in a [[lung cancer]] diagnosis. [[False-positive]] exams may result in unnecessary [[Non small cell lung cancer diagnostic study of choice|invasive diagnostic procedures]]. | |||
*'''Chest x-ray and/or sputum cytology''':<ref name="JAMA">Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.</ref> | |||
**Pros: | |||
***[[Screening (medicine)|Screening]] with [[Chest X-ray|chest x-ray]] and/or [[sputum cytology]] does not reduce [[Mortality rate|mortality]] from [[lung cancer]] in the general population or in ever-smokers. | |||
**Cons: | |||
***[[False positive]] exams | |||
***The majority of all positive [[Chest X-ray|chest x-ray]] [[Screening (medicine)|screening]] exams do not result in a [[Lung cancer|lung cance]]<nowiki/>r diagnosis. | |||
***[[False-positive test result|False-positive]] exams result in unnecessary [[Non small cell lung cancer diagnostic study of choice|invasive diagnostic procedures]]. | |||
'''Overdiagnosis''' | |||
* Based on current evidence, the majority of non-small cell lung cancers detected by [[Screening (medicine)|screening]] [[Chest X-ray|chest x-ray]] and/or [[sputum cytology]] appear to represent [[Overdiagnosis|overdiagnosed]] [[cancer]].<ref name="JAMA">Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.</ref> | |||
**The magnitude of [[overdiagnosis]] appears to be between 5% and 25%. | |||
**These [[Cancer|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 natural history, complications and prognosis|smoking-associated comorbidities]] that increase risk propagation. | |||
==Screening Guidelines== | |||
The | *The table below summarizes the screening eligibility for non-small cell lung cancer screening by different organizations. | ||
{| style="border: 5px; font-size: 90%; margin: 5px; width: 1000px" align="center" | |||
! colspan="3" style="padding: 5px 5px; background: #4479BA; font-weight: bold; text-align:center;" |{{fontcolor|#FFF|''' Screening Guidelines for Non Small Cell Lung Cancer''' <br><SMALL>Adapted from Center of Disease Control and Prevention (CDC). 2016 <ref name="CDC"> Screening for non-small cell lung cancer. http://www.cdc.gov/cancer/lung/pdf/guidelines.pdf Accessed on February 22, 2016 </ref></SMALL>}} | |||
| valign="top" | | |||
|+ | |||
|- | |||
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Organization}} | |||
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Groups eligible for screening}} | |||
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Year}} | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | American Academy of Family Practice | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Evidence is insufficient to recommend for or against screening | |||
| style="padding: 5px 5px; background: #F5F5F5;" | 2013 | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | American Association of Thoracic Surgery | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
2012 | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | American Cancer Society | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
2015 | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | American College of Chest Physicans | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
Age 55 to 74 years with ≥30 pack year smoking history,who either currently smoke or have quit within the past 15 years | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
2013 | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | American Society of Clinical Oncology | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
Age 55 to 74 years with ≥30 pack year smoking history,who either currently smoke or have quit within the past 15 years | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
2012 | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | American Lung Association | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
Age 55 to 74 years with ≥ 30 pack year smoking history and no history of lung cancer | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
2012 | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Medicaid Services | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
Age 55 to 77 years with ≥ 30 pack year smoking history and smoking cessation < 15 years | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
2015 | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | National Comprehensive Cancer Network | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
2015 | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | U.S Preventive Services Task Force | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
Age 55 to 80 years with ≥30 pack year smoking history and smoking cessation < 15 years | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
2013 | |||
|} | |||
==References== | ==References== | ||
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Latest revision as of 16:58, 10 January 2019
Non Small Cell Lung Cancer Microchapters |
Differentiating Non Small Cell Lung Cancer from other Diseases |
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Non small cell lung cancer screening On the Web |
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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
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
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.
- Pros:
- 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.
- Pros:
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
- 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
- ↑ Lung Cancer: Screening http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening. Accessed on February 3, 2016
- ↑ Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.
- ↑ 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
- ↑ 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
- ↑ 6.0 6.1 Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.
- ↑ Screening for non-small cell lung cancer. http://www.cdc.gov/cancer/lung/pdf/guidelines.pdf Accessed on February 22, 2016