title: Evaluating efficacy of current lung cancer screening guidelines.
abstract: Objective Current lung cancer screening criteria based primarily on outcomes from the National Lung Screening Trial may not adequately capture all subgroups of the population at risk. We aimed to evaluate the efficacy of lung cancer screening criteria recommended by the United States Preventive Services Task Force, Centers for Medicare and Medicaid Services, and the National Comprehensive Cancer Network in identifying known cases of lung cancer. Methods An investigation of the Stony Brook Cancer Center Lung Cancer Evaluation Center's database identified 1207 eligible, biopsy-proven lung cancer cases diagnosed between January 1996 and March 2016. Age at diagnosis, smoking history, and other known risk factors for lung cancer were used to determine the proportion of cases that would have met current United States Preventive Services Task Force, Centers for Medicare and Medicaid Services, and National Comprehensive Cancer Network eligibility requirements for lung cancer screening. Results Of the 1046 ever smokers in the study, 40% did not meet the National Lung Screening Trial age requirements, 20% did not have a ≥30 pack year smoking history, and approximately one-third quit smoking >15 years before diagnosis, thus deeming them ineligible for screening. Applying the United States Preventive Services Task Force, Centers for Medicare and Medicaid Services, and National Comprehensive Cancer Network eligibility criteria to the Stony Brook Cancer Center's Lung Cancer Evaluation Center cases, 49.2, 46.3, and 69.8%, respectively, would have met the current lung cancer screening guidelines. Conclusions The United States Preventive Services Task Force and Centers for Medicare and Medicaid Services eligibility criteria for lung cancer screening captured less than 50% of lung cancer cases in this investigation. These findings highlight the need to reevaluate the efficacy of current guidelines and may have major public health implications.
authors.affiliation: 1 Department of Family, Population and Preventive Medicine, Stony Brook Medicine, Stony Brook, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Nemesure
authors.affiliation: 2 Department of Radiology, Stony Brook Medicine, Stony Brook, USA.
authors.forename: April
authors.initials: A
authors.lastname: Plank
authors.affiliation: 3 Stony Brook Cancer Center, Stony Brook Medicine, Stony Brook, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Reagan
authors.affiliation: 4 Department of Surgery, Stony Brook Medicine, Stony Brook, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Albano
authors.affiliation: 2 Department of Radiology, Stony Brook Medicine, Stony Brook, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Reiter
authors.affiliation: 4 Department of Surgery, Stony Brook Medicine, Stony Brook, USA.
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Bilfinger
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration / Q000592:standards; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods; D014481:United States
keywords: Lung cancer; early detection; low-dose computed tomography; lung cancer risk factors; screening guidelines