Lung cancer screening criteria miss the mark in younger, long-term quitters

  • Luo YH & al.
  • Lancet Oncol
  • 26 Jun 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with lung cancer who quit smoking ≥15 years before their diagnosis and those who were ≤5 years younger than the recommended age cutoff, but otherwise met US Preventive Services Task Force (USPSTF) lung cancer screening criteria, had a similar mortality risk as people who meet all USPSTF criteria.

Why this matters

  • These findings, along with earlier research suggesting that nearly two-thirds of patients with lung cancer do not meet USPSTF screening criteria, suggest a guidelines revision could improve patient outcomes.  
  • A similar recent study focused on African Americans.

Study design

  • Prospective, observational cohort, multicenter study.
  • 8739 patients diagnosed with lung cancer between 1997 and 2017 from hospital and community cohorts.
  • Median follow-up, 6.5 years.
  • Funding: NIH; Mayo Clinic Foundation.

Key results

  • 6627 of the overall cohort met USPSTF criteria.
  • 5-year OS was 27% in smokers who quit within the last 30 years, 22% in those
  • 5-year OS was not significantly different between long-term quitters and the USPSTF group (hospital cohort HR, 1.02 [P=.72]; community cohort HR, 0.97 [P=.82]) or those
  • Results were similar after propensity matching.

Limitations

  • Unmeasured confounders could have influenced OS.

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