The current screening criteria for lung cancer may not be sensitive enough to protect people at risk, given the recent decline in smoking rates, according to a report published in the February 24 issue of JAMA. 


The U.S. Preventive Services Task Force (USPSTF) criteria for lung cancer screening using low-dose CT includes asymptomatic adults aged 55 years to 80 years, having a 30 pack-year smoking history, and currently smoking or having quit within the last 15 years. Ping Yang, MD, PhD, and colleagues examined data on 140,000 people who were older than age 20 years from 1984 through 2011, during which time, 1,351 developed primary lung cancer.

The researchers found that the number of patients who would have been screened according to the USPSTF criteria decreased among women from 52% to 37% and among men from 60% to 50%. The proportion of patients with lung cancer who smoked at least 30 pack-years declined during the study period and that of patients who had quit more than 15 years ago increased, a finding that Dr. Yang said had the greatest relevance to CT screening.


Dr. Yang suggested that the screening criteria should be adjusted to include some smokers who have smoked less than 30 pack-years or who have quit more than 15 years ago.