Based on data published from 2006 through 2012 by several groups, in 2013 the US Preventive Services Task Force, that governmental agency in charge of health-care policy, came up with new guidelines for screening for lung cancer in high-risk groups. Their guidelines were published in the Annals of Internal Medicine. If you wish a copy of this paper, or subsequent updated guidelines (see below) request them from Dr. Stark by filling out the form on the right. In it the group recommended annual low-dose CAT scans of the lungs for people between the ages of 55 and 80 who had at least 30 pack-years of smoking history (packs per day X years smoked) — and either current smokers or those who had quit within the previous 15 years. This announcement made big news in the medical community because previously it had been thought that screening for lung cancer didn’t work to reduce mortality. Those guidelines were updated in 2021 to include people with only 20 pack-years and were published in the Journal of the American Medical Association. Despite these guidelines it has been estimated that only 20% of Americans who should be screened actually are. So has this screening done any good considering the lack of compliance by the medical profession and their patients?
A group of investigators, led by Dr. Alexandra Potter of Massachusetts General Hospital, used cancer-related databases to try to answer this question. Their article was published in British Medical Journal. They looked at the SEER database and the National Cancer Database, together covering a large swath of the US population. They looked at newly diagnosed lung cancer patients from 2010 until 2018 to see whether the stage at diagnosis had shifted, and whether there was a change in mortality. After the 2013 guidelines were released, the percentage of patients diagnosed with the earliest form of lung cancer, stage I, rose by 7% per year. The percentage of patients with stage IV (widespread disease) shrank by 4.4%. Between 2010 and ’18 the overall survival of all lung cancer patients rose from a median of 14 to 26 months.
Dr. Stark speaks, “These results are astonishing. Think of what we could accomplish if all people at high risk for lung cancer agreed to get screened, and if their doctors got with the program. The overall mortality would fall even more dramatically. Let’s hope this article gets wide distribution.”