A new study from Northwestern Medicine now shows that Lung cancer screening guidelines Researchers say it’s time for a big change, as they may be missing out on most Americans who develop the disease.
The study, published in JAMA Network Open, analyzed nearly 1,000 lung cancer patients treated at Northwestern Medicine between 2018 and 2023.
The goal was to determine how many of these patients would be eligible for screening under existing guidance from the United States Preventive Services Task Force (USPSTF).
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The USPSTF currently recommends an annual CT scan for adults ages 50 to 80 who have a history of smoking 20 packs per year (equivalent to smoking one pack of cigarettes a day for 20 years). And either still smoking or quit within the past 15 years.
Only about 35% of people diagnosed with lung cancer meet current criteria to be screened.
This means around two-thirds of patients were not flagged for testing before receiving a diagnosis.
“This approach not only misses many patients who have quit smoking in the past or who do not fully meet high-risk criteria, but it also misses other patients who are at risk for smoking. lung cancerNon-smokers, etc.,” Dr. Luis Herrera, a thoracic surgeon at Orlando Health, told Fox News Digital.
The study notes that these patients tend to have adenocarcinoma, the most common type of lung cancer among non-smokers.
Those who did not follow the guidelines were often women, people of Asian descent, and people with symptoms such as: never smokedThe research revealed that.
The research team also compared survival outcomes. Patients who did not meet screening criteria had a median survival of 9.5 years, compared with 4.4 years for those who did.
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Although this difference is partly reflected in tumor biology Researchers say this highlights how current screening rules are failing to capture a wide range of cases that could be treated earlier.
“Currently, participation rates for lung cancer screening among eligible patients based on smoking history are quite low,” said Herrera, who was not involved in the study. This is likely due to the complexity of risk-based criteria and the stigma associated with smoking and lung cancer, he added.
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To test the alternative, the researchers modeled a different approach. The idea is to screen everyone between the ages of 40 and 85, regardless of smoking history.
Under that universal age-based model, approximately 94% of cancers in the cohort should be detected.
They estimate that such a change could prevent about 26,000 deaths each year in the United States, at a cost of about $101,000 per life saved.
The study highlighted that this is much more cost-effective than current breast or breast cancer screening programs. colorectal cancerEach life saved costs between $890,000 and $920,000.
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Herrera noted that there are many challenges to implementing lung cancer screening, including a lack of awareness and some health care providers not recommending screening tests.
However, he added, “The cost of the test is covered by most health insurance plans, and many providers offer discounts to uninsured patients.”
Lung cancer remains the nation’s deadliest cancer, killing more people each year than colon, prostate, or cancer. breast cancer Combined. But millions of at-risk people never get tested because of narrow eligibility criteria based on smoking history.
Northwestern Medicine researchers argue that expanding screening tests to all adults in the targeted age range could help close these gaps, especially for groups that are often underdiagnosed.
This study was conducted at a single academic center, so the patient population may not be representative of the entire U.S. population. I also looked back on this existing dataTherefore, the researchers acknowledged that they cannot prove how the new model would work in an actual screening program.
Cost and mortality estimates are based on assumptions that can change depending on how screening is performed.
The researchers also noted that they did not fully account for the potential downsides of more widespread screening, such as false positives and unnecessary follow-up.
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Patients who are not eligible for lung cancer screening have other opportunities. Lung evaluationThis includes “cardiac calcium scores, CT scans, and other imaging modalities that can at least assess for suspicious nodules in the lungs,” Herrera added.
