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Edad de inicio de cribado de cáncer de pulmón adaptada al riesgo para exfumadores
Clara Frick1,2, Lára R Hallsson3, Uwe Siebert3,4,5,6,7,8
1Division of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.
JAMA network open
|February 3, 2026
Resumen
El cribado del cáncer de pulmón se puede personalizar para exfumadores. Las edades de inicio adaptadas al riesgo, basadas en el tiempo transcurrido desde que se dejó de fumar, pueden optimizar el cribado para personas con antecedentes de tabaquismo intenso.
Área de la Ciencia:
- Oncología; Medicina Preventiva; Epidemiología
Sus antecedentes:
- El US Preventive Services Task Force (USPSTF) recomienda el cribado del cáncer de pulmón para personas de 50 a 80 años con antecedentes de tabaquismo de ≥20 paquetes-año y ≤15 años sin fumar.
- Las directrices actuales pueden no personalizar adecuadamente el cribado para exfumadores según sus perfiles de riesgo individuales relacionados con el tiempo desde la cesación.
Objetivo del estudio:
- Desarrollar una estrategia personalizada de cribado del cáncer de pulmón definiendo edades de inicio de cribado adaptadas al riesgo basadas en el tiempo desde la cesación del tabaquismo.
- Refinar las recomendaciones de cribado del cáncer de pulmón para exfumadores empedernidos.
Principales métodos:
- Estudio de cohortes que utiliza datos longitudinales del UK Biobank (n=86.035).
- El análisis incluyó a exfumadores o fumadores empedernidos (≥20 paquetes-año) de 50 años o más.
- Los modelos multivariables de riesgos proporcionales de Cox extendidos evaluaron la asociación entre la duración de la cesación del tabaquismo, los paquetes-año, la edad y la incidencia de cáncer de pulmón a 10 años.
Principales resultados:
- El estudio identificó Períodos de Aplazamiento del Riesgo (RPP) para la cesación del tabaquismo.
- Los RPP variaron significativamente según el tiempo transcurrido desde que se dejó de fumar: 2,7 años (≤5 años), 6,2 años (6-10 años), 10,4 años (11-15 años) y 17,1 años (>15 años).
- Las edades de inicio del cribado adaptadas al riesgo podrían oscilar entre 53 y 67 años, en comparación con la edad recomendada de 50 años por la USPSTF para fumadores actuales.
Conclusiones:
- Este estudio del UK Biobank proporciona una base empírica para las edades de inicio del cribado del cáncer de pulmón adaptadas al riesgo para exfumadores empedernidos.
- La personalización del inicio del cribado basada en el tiempo transcurrido desde la cesación del tabaquismo puede alinearse mejor con el riesgo individual de cáncer de pulmón.
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