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Former cigarette smokers may still need lung cancer screening
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Patients who have quit smoking for decades may still be at risk for lung cancer, and researchers recommend screening for these patients long after guidelines suggest they may not be at risk, according to recent research.
“A decline in smoking rates has been, and continues to be, a critical step to reduce lung cancer risk and deaths,” Ping Yang, MD, PhD, epidemiologist at Mayo Clinic Cancer Center in Rochester, Minnesota, stated in a press release. “But, it also means that fewer people have benefited from early detection of lung cancer, because more patients don’t qualify for low-dose CT scans.”
Yang and colleagues evaluated two cohorts of 5,988 patients within a hospital and community among whom primary lung cancer diagnosed between 1997 and 2011, according to the abstract. The researchers compared benefit to harm and cost to effectiveness ratios to determine whether certain subgroups of patients could have been diagnosed with lung cancer through other methods not outlined in the U.S. Preventative Task Force screening criteria.
They found that patients in the largest subgroup were those with a smoking history of 30 pack-years or more, had quit between 15 years and 30 years ago and were aged 55 to 80 years, according to the abstract.
“We were surprised to find that the incidence of lung cancer was proportionally higher in this subgroup, compared to other subgroups of former cigarette smokers,” Yang stated in the release. “The common assumption is that after a person has quit for so many years, the lung cancer rate would be so low that it wouldn’t be noticeable. We found that assumption to be wrong. This suggests we need to pay attention to people who quit smoking more than 15 years ago, because they are still at high risk for developing lung cancer.”
This subgroup comprised 12% of the hospital patient group and 17% of the community group, the researchers noted. They recommended adding 19% more CT examinations to detect 16% more cases than would be identified through the U.S. Preventative Task Force criteria. They found the increase in false-positive results was 0.6%, overdiagnosis was 0.1% and radiation-related lung cancer deaths were 4.0%, according to the abstract – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.
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