Expanding lung cancer screening eligibility criteria could save tens of thousands of lives
Expanding eligibility criteria for low-dose CT lung cancer screening could potentially save tens of thousands of additional lives, according to new research.
Lung cancer is the leading cause of cancer-related mortality worldwide. Yet, despite treatment advances, five-year survival rates are only 21%, with about 75% of patients receiving diagnoses at advanced stages, experts write in JAMA Network Open.
Broadening who qualifies for such CT imaging, however, could begin to reverse these numbers. Based on an analysis of nearly 1,000 individuals with lung cancer, only about 35% met eligibility criteria established by the U.S. Preventive Services Task Force. But switching to age-based criteria for all individuals between 40 to 85 would result in the detection of nearly 94% of cancers, preventing at least 26,124 deaths annually.
“These findings suggest that current screening guidelines miss most patients with lung cancer, and age-based screening could improve detection and cost-effectiveness while reducing disparities,” Hee Chul Yang, MD, with the Northwestern University Feinberg School of Medicine, Chicago, and co-authors concluded.
The study analyzed data from all patients diagnosed with lung cancer between 2018 and 2023. Expanding USPSTF criteria to 40 to 85 (from the current 50 to 80) and 10 pack or more pack years (from the current 20) would increase the detection rate to 62.1%, the authors estimated. However, moving to universal age-based screening would add over 30 percentage points to that total. Current USPSTF guidelines missed nearly two-thirds of cases, they estimated, disproportionately excluding women, individuals from minority groups and never-smokers with favorable prognoses.
Universal age-based lung cancer screening would result in costs of approximately $101,000 per life saved, the authors estimated, far shy of the figures for cancers of the breast ($890,000) and colon/rectum ($920,000). Age-based screening achieving 30% stage 1 detection would save about $24.76 billion annually in treatment costs alone, far exceeding the $2.6 billion screening program cost.
“Policy revisions should expand eligibility, address nontobacco risks, and mitigate implementation barriers to ensure equitable early detection,” the authors concluded.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.