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American Lung Association issues guidelines for lung cancer screening


American Lung Association issues guidelines for lung cancer screening


April 27, 2012—Citing recent research that identifies low-dose computed tomography (CT) as a promising tool for finding lung cancer before symptoms appear, the American Lung Association (ALA) has released new interim guidelines on lung cancer screening.

The guidelines were developed to assist decision making about screening among smokers who are at risk for lung cancer and their doctors. Officials emphasized that testing is not for everyone and that it has risks as well as benefits.

According to the ALA, only low-dose CT scans—not x-rays—are recommended for screening. The test should be done at a facility experienced in conducting the scans, and it should have a multidisciplinary team that can provide comprehensive follow-up if necessary.

Good screening candidates must meet all of these criteria:

  • Be current or former smokers.
  • Be between the ages of 55 and 74.
  • Have a smoking history of at least 30 pack-years (one pack per day for 30 years, two packs per day for 15 years, etc.)
  • Have no history of lung cancer.

Low-dose CT provides more detailed images of the lungs than x-ray alone yet involves less radiation than a standard chest CT.

Research has shown that using low-dose CT may reduce lung cancer deaths by 20 percent compared to using chest x-rays. These findings are particularly hopeful because lung cancer is the nation’s leading cause of cancer death and has a five-year survival rate of only 15 percent, according to the ALA.

Still, officials cautioned that the test can produce false positive results, meaning that it may find something suspicious that proves to be nothing serious after additional—and potentially risky—procedures are done.

In addition, the ALA noted that people undergoing the test should realize that a negative result does not absolutely guarantee that no cancer is present or that cancer will not develop in the future.

The ALA advises people to check with their insurance plan before having the test. Because research on low-dose CT is relatively new, health plans and Medicare may not cover the scan or necessary follow-up tests. As a result, patients may have to pay for them out of pocket.

People should also remember the importance of taking steps to avoid lung cancer in the first place.

“Never starting smoking and quitting smoking still remains the best way to prevent lung cancer,” said Norman H. Edelman, MD, the ALA’s chief medical officer. “Additionally, it is also important for people to have their homes tested for radon, as radon exposure can increase the risk of lung cancer.”

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