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ACR Appropriateness Criteria® Lung Cancer Screening.
, Edwin F Donnelly1, Ella A Kazerooni2
1Panel Chair, Vanderbilt University Medical Center, Nashville, Tennessee.
Journal of the American College of Radiology : JACR
|November 6, 2018
Summary
Lung cancer screening with low-dose CT is recommended for individuals aged 55-80 with a significant smoking history. Guidelines help determine appropriate screening for those with additional risk factors.
Area of Science:
- Oncology
- Radiology
- Public Health
Background:
- Lung cancer is a leading cause of cancer death globally.
- Smoking is the primary risk factor for lung cancer development.
- Identifying high-risk individuals for early detection is crucial.
Purpose of the Study:
- To outline evidence-based guidelines for lung cancer screening using low-dose CT.
- To define specific criteria for patient eligibility for lung cancer screening.
- To address the appropriateness of screening in cases with additional risk factors.
Main Methods:
- Review and synthesis of current medical literature.
- Application of established methodologies like RAND/UCLA and GRADE.
- Annual review by a multidisciplinary expert panel.
Main Results:
- Low-dose CT screening is recommended for individuals aged 55-80 with ≥30 pack-year smoking history (current or former smokers within 15 years).
- Screening is controversial but may be considered for those not meeting criteria but with additional risk factors.
- Screening is not recommended for individuals younger than 50 or older than 80, or those with <20 pack-year history and no other risk factors.
Conclusions:
- The American College of Radiology Appropriateness Criteria provide a framework for lung cancer screening decisions.
- Guidelines aim to optimize screening benefits while minimizing potential harms.
- Expert opinion may guide decisions in cases with limited or equivocal evidence.
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