title: Would screening for lung cancer benefit 75- to 84-year-old residents of the United States?
abstract: BACKGROUND
  The National Lung Screening Trial demonstrated that screening for lung cancer improved overall survival (OS) and reduced lung cancer mortality in the 55- to 74-year-old age group by increasing the proportion of cancers detected at an early stage. Because of the increasing life expectancy of the American population, we investigated whether screening for lung cancer might benefit men and women aged 75-84 years.
  
  
  METHODS
  Rates of non-small cell lung cancer (NSCLC) from 2000 to 2009 were calculated in both younger and older age groups using the surveillance epidemiology and end reporting database. OS and lung cancer-specific survival (LCSS) in patients with Stage I NSCLC diagnosed from 2004 to 2009 were analyzed to determine the effects of age and treatment.
  
  
  RESULTS
  The per capita incidence of NSCLC decreased in the 55-74 cohort, but increased in the 75-84 cohort over the study period. Crude lung cancer death rates in the two age groups who had no specific treatment were 39.5 and 44.9%, respectively. These rates fell in both age groups when increasingly aggressive treatment was used. Rates of OS and LCSS improved significantly with increasingly aggressive treatment in the 75-84 age group. The survival benefits of increasingly aggressive treatment in 75- to 84-year-old females did not differ from their counterparts in the younger cohort.
  
  
  CONCLUSIONS
  Screening for lung cancer might be of benefit to individuals at increased risk of lung cancer in the 75-84 age group. The survival benefits of aggressive therapy are similar in females between 55-74 and 75-84 years old.
authors.affiliation: Department of Radiation Oncology, University of Massachusetts Medical Center , Worcester, MA , USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Varlotto
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Northwestern Memorial Hospital , Chicago, IL , USA.
authors.forename: Malcolm M
authors.initials: MM
authors.lastname: Decamp
authors.affiliation: Department of Radiation Oncology, Pittsburgh Cancer Institute , Pittsburgh, PA , USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Flickinger
authors.affiliation: Pennsylvania State University College of Medicine , Hershey, PA , USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Lake
authors.affiliation: Department of Radiation Oncology, Beth Israel Deaconess Medical Center , Boston, MA , USA.
authors.forename: Abram
authors.initials: A
authors.lastname: Recht
authors.affiliation: Pennsylvania State University College of Medicine , Hershey, PA , USA ; Penn State Hershey Cancer Institute , Hershey, PA , USA.
authors.forename: Chandra P
authors.initials: CP
authors.lastname: Belani
authors.affiliation: Pennsylvania State University College of Medicine , Hershey, PA , USA ; Heart and Vascular Institute, Penn State Hershey Medical Center , Hershey, PA , USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Reed
authors.affiliation: Pennsylvania State University College of Medicine , Hershey, PA , USA ; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Penn State Hershey Medical Center , Hershey, PA , USA.
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Toth
authors.affiliation: Pennsylvania State University College of Medicine , Hershey, PA , USA ; Penn State Hershey Cancer Institute , Hershey, PA , USA.
authors.forename: Heath B
authors.initials: HB
authors.lastname: Mackley
authors.affiliation: Department of Medicine, Penn State College of Medicine , Hershey, PA , USA.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Sciamanna
authors.affiliation: Pennsylvania State University College of Medicine , Hershey, PA , USA ; Penn State Hershey Cancer Institute , Hershey, PA , USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Lipton
authors.affiliation: Pennsylvania State University College of Medicine , Hershey, PA , USA ; Penn State Hershey Cancer Institute , Hershey, PA , USA.
authors.forename: Suhail M
authors.initials: SM
authors.lastname: Ali
authors.affiliation: Department of Radiology, Penn State College of Medicine , Hershey, PA , USA.
authors.forename: Richkesvar P M
authors.initials: RP
authors.lastname: Mahraj
authors.affiliation: Pennsylvania State University College of Medicine , Hershey, PA , USA ; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Penn State Hershey Medical Center , Hershey, PA , USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Gilbert
authors.affiliation: Department of Healthcare Policy and Research, Virginia Commonwealth University College of Medicine , Richmond, VA , USA.
authors.forename: Nengliang
authors.initials: N
authors.lastname: Yao
keywords: elderly; lung cancer; radiotherapy; screening; thoracic surgery