Lung mass screening: Difference between revisions
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==Overview== | ==Overview== | ||
According to the U.S. Preventive Services Task Force (USPSTF) | According to the U.S. Preventive Services Task Force (USPSTF), screening for suspected 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).<ref name=“lung screen">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><ref name=“ludng">National Lung Screening Trial. Wikipedia. https://en.wikipedia.org/wiki/National_Lung_Screening_Trial Accessed on February 4,2016</ref><ref name="US">Recommendations. US preventive services task force(2016) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=solitary_pulmonary_nodule Accessed on March, 15th 2016</ref><ref name="NEJM">McWilliams A, Tammemagi MC, Mayo JR, et. al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med. 2013 Sep 5;369(10):910-9. doi:10.1056/NEJMoa1214726.</ref> | ||
==Screening== | ==Screening== | ||
'''Guidelines''' | |||
*According to the U.S. Preventive Services Task Force (USPSTF), screening for suspected 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).<ref name=“lung screen">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><ref name=“ludng">National Lung Screening Trial. Wikipedia. https://en.wikipedia.org/wiki/National_Lung_Screening_Trial Accessed on February 4,2016</ref><ref name="US">Recommendations. US preventive services task force(2016) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=solitary_pulmonary_nodule Accessed on March, 15th 2016</ref><ref name="NEJM">McWilliams A, Tammemagi MC, Mayo JR, et. al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med. 2013 Sep 5;369(10):910-9. doi:10.1056/NEJMoa1214726.</ref> | |||
* According to the [[clinical practice guideline]] issued by the [[American College of Chest Physicians]] (CHEST) in 2013, screening for suspected 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> | |||
:* 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. | |||
* Chest x-ray <ref name="JAMA">Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.</ref> | |||
:*Benefits | |||
::*Screening with chest x-ray does not reduce mortality from lung cancer in the general population or in ever-smokers. | |||
:* Harms | |||
::* False positive exams | |||
::* The majority of 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. | |||
'''Overdiagnosis''' | |||
* Based on current evidence, the majority of solitary pulmonary nodules detected by screening chest x-ray appear to represent over-diagnosed 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 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== | |||
{{Reflist|2}} | |||
{{WH}} | |||
{{WS}} | |||
[[Category:Disease]] | |||
[[Category:Pulmonology]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 17:24, 22 March 2016
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Lung Mass Microchapters |
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Diagnosis |
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Treatment |
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Lung mass screening On the Web |
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American Roentgen Ray Society Images of Lung mass screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
According to the U.S. Preventive Services Task Force (USPSTF), screening for suspected 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][3][4][5]
Screening
Guidelines
- According to the U.S. Preventive Services Task Force (USPSTF), screening for suspected 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][3][4][5]
- According to the clinical practice guideline issued by the American College of Chest Physicians (CHEST) in 2013, screening for suspected 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.[6]
Strategies
- Low-dose helical computed tomography[7]
- 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.
- Chest x-ray [8]
- Benefits
- Screening with chest x-ray does not reduce mortality from lung cancer in the general population or in ever-smokers.
- Harms
- False positive exams
- The majority of 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.
Overdiagnosis
- Based on current evidence, the majority of solitary pulmonary nodules detected by screening chest x-ray appear to represent over-diagnosed cancer.[8]
- 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.
References
- ↑ 1.0 1.1 Lung Cancer: Screening http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening. Accessed on February 3, 2016
- ↑ 2.0 2.1 Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.
- ↑ 3.0 3.1 National Lung Screening Trial. Wikipedia. https://en.wikipedia.org/wiki/National_Lung_Screening_Trial Accessed on February 4,2016
- ↑ 4.0 4.1 Recommendations. US preventive services task force(2016) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=solitary_pulmonary_nodule Accessed on March, 15th 2016
- ↑ 5.0 5.1 McWilliams A, Tammemagi MC, Mayo JR, et. al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med. 2013 Sep 5;369(10):910-9. doi:10.1056/NEJMoa1214726.
- ↑ 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
- ↑ 8.0 8.1 Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.