Saturday, May 18, 2013
More recommendations for lung cancer screening
The American College of Chest Physicians (ACCP) recently published the third edition of Diagnosis and Management of Lung Cancer: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Included in these guidelines are recommendations for lung cancer screening.
The current ACCP recommendations are:
1. Chest radiography should not be used for screening at risk patients.
2. Sputum cytology should not be used for screening at risk patients.
3. At risk patients who meet National Lung Screening Trial inclusion criteria (age 55-74, at least 30 pack-years, and if former smokers, who quit fewer than 15 years ago) should be offered annual low dose helical CT screening
4. Screening for at-risk patients who do not meet NLST inclusion criteria or who have other significant comorbidities should not be offered screening.
Of important note, the ACCP explicitly states that CT screening for lung cancer should only be performed “in settings that can deliver the comprehensive care provided to National Lung Screening Trial participants.” The ACCP also advocates for creation of a registry of screened patients and for development of quality metrics similar to those used in screening mammography.
The full guidelines are published in the May 2013 issue of Chest.