"Applying screening tests to a population without symptoms of disease can certainly benefit some people but also has the potential for some harms," said lead author Daniel Jonas, MD, MPH, who conducted most of this research while he was a professor at the UNC School of Medicine. "In the case of lung cancer screening, we now have more certainty that some individuals will benefit, with some lung cancer deaths prevented, and we also know others will be harmed."
The results of the 10-year National Lung Screening Trial (NLST) showed that CT scans did detect lung cancer better than conventional x-ray in current and previous heavy smokers. Based on those results and this review the United States Preventive services Task Force recommended extending the screening criteria from anyone 50-55 years old who had a 30 pack-year smoking history to anyone with a 20 pack-year history. A pack-year is smoking an average of one pack of cigarettes a day for one year.
Extending the criteria to 20 pack years was done to broaden the number of people being screened, and to include more African Americans, who have a higher lung cancer risk even with lower levels of smoking.
Harms from screening stem from false positives. The large majority of the nodules found on screening are not cancer, others are suspicious. The suspicious lesions result in additional screening, with additional x-ray exposure as well as mental distress of living with an uncertain diagnosis of possible cancer.
Extending the criteria to 20 pack years was done to broaden the number of people being screened, and to include more African Americans, who have a higher lung cancer risk even with lower levels of smoking.
Harms from screening stem from false positives. The large majority of the nodules found on screening are not cancer, others are suspicious. The suspicious lesions result in additional screening, with additional x-ray exposure as well as mental distress of living with an uncertain diagnosis of possible cancer.
Source: University of North Carolina press release.
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