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In 2021 the United States task force lowered the age at which lung screening starts from 55 to 50 and halved the smoking history needed from 30 to 20 pack-years, roughly doubling the number of people eligible.
The 2021 update of the United States Preventive Services Task Force recommendation on lung cancer screening, replacing the 2013 statement. It recommends annual low-dose computed tomography in adults aged 50 to 80 years with a 20 pack-year smoking history who currently smoke or have quit within the past 15 years, a B recommendation, and says screening should stop once a person has not smoked for 15 years or develops a problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.
The widened criteria were driven by a commissioned systematic review and a collaborative modelling study, and by evidence that the 2013 thresholds excluded groups at high risk, Black smokers in particular (paper-aldrich-uspstf-screening-african-american-smokers-jama-oncol-2019).
The document that defines who is offered a scan in the United States, and therefore the document any argument about the screening eligibility gap has to engage with. Eligibility is still defined by pack-years and years since quitting rather than by an individual risk estimate.
Lung screening works when it uses volumetric nodule management, and it works against a no-screening control. The protocol underpins the UK Targeted Lung Health Check programme and European recommendations. Benefit in women remains less precisely estimated.
The clearest published demonstration that a screening eligibility rule can be accurate on average and systematically wrong for a group. It is the empirical core of the argument for replacing pack-year thresholds with individual risk models.
The deprivation gradient in lung cancer is not only about who gets the disease. Among people who already have it, and at the same stage, poorer patients are less likely to be offered the treatment that works.
For people with a heavy smoking history, an annual low-dose CT scan is one of the few screening tests proven to reduce cancer deaths. Most abnormal scans are not cancer, so screening must be paired with careful nodule management. It does not apply to never-smokers or light smokers.
Shares NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms, Overdiagnosis, NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers, Early detection roadmap: organ screening → blood tests for many cancers and the tag lung-evidence.
Shares JAMA, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Prevention we already have is not deployed, The hardest cancers are found late and the tag lung-evidence.
Shares Treat lung cancer in never-smokers as its own disease, with its own detection programme, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Prevention we already have is not deployed, The hardest cancers are found late and the tag lung-evidence.
Shares Treat lung cancer in never-smokers as its own disease, with its own detection programme, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, The hardest cancers are found late, Lung cancer (all types) and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Prevention we already have is not deployed, Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.
Shares Prevention we already have is not deployed, Most of the world has almost no cancer care, Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, The hardest cancers are found late, Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.
Shares Close the United Kingdom lung cancer gaps the UK page names: screening rollout, diagnostic pathway, molecular testing and drug access, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.