The draft recommendation posted by the USPSTF for public comment
marks the first time in history in which a specific recommendation for
screening for asymptomatic smokers to find lung cancer prior to the
development of symptoms has been endorsed using low-dose CT scans for
smokers with 30 pack years tobacco exposure and between the ages of 55
The AATS strongly agrees with the USPSTF draft recommendation. Specifically, the AATS supports:
1) Performing the screening low dose CT scan test once a year, each year.
2) Continuing the screening up to age 80. The AATS believes future refinement of the screening recommendations can be expected to cover Americans over the age of 80 with preserved health.
3) The need to allow Americans with an abnormal screening scan to be evaluated in a specialized center with particular expertise in lung cancer, especially with state-of-the-art experience in minimally invasive diagnostic and surgical methods to treat early stage lung cancer.
4) The plan to link lung cancer screening with access to smoking cessation programs.
In September 2011 the AATS created a multispecialty Lung Cancer
Screening and Surveillance Task Force spearheaded by Michael T.
Jaklitsch, MD, Associate Professor, Department of Surgery, Harvard
Medical School, and Francine L. Jacobson, MD, MPH, Assistant Professor
of Radiology, Harvard Medical School. With input from leaders in
Radiology, Pulmonary Medicine, Medical Oncology, Radiation Oncology,
Pathology, and Thoracic Surgery, in May 2012 this task force, issued a
set of clinical guidelines that strongly recommended lung cancer
screening using low-dose CT scans on an annual basis for smokers between
the ages of 55 and 79. The close alignment of the USPSTF draft
guidelines are based on the best scientific evidence currently
“Lung cancer is a common and lethal disease. Nearly a quarter million
new lung cancer victims will be identified this year,” explains, Dr.
Jaklitsch. “Sadly, only 15% of these victims will be found with early
stage disease. Yet lung cancer can be cured up to 88% of the time that
early stage disease is found. Screening programs have been successful in
reducing cancer deaths related to breast cancer (mammography), colon
cancer (colonoscopy) and prostate cancer (PSA and rectal exams). Until
now there has been no screening test for lung cancer, even though lung
cancer kills more Americans than breast cancer, colon cancer, and
prostate cancer combined. This historic recommendation will establish
lung cancer screening and dramatically reduce deaths from this
Symptoms of lung cancer include difficulty breathing, coughing up
blood, brain metastases, painful bone metastases, metastases to other
organs, profound weight loss, and weakness.
Nearly every American has witnessed the suffering caused by lung
cancer. AATS President David J. Sugarbaker, MD, Richard E. Wilson
Professor, Department of Surgery, Harvard Medical School, comments, “No
one deserves to suffer the effects of an advanced stage of disease if a
test is currently available to detect and cure the disease prior to
symptoms. The time has finally come to use modern technology to prevent
this type of suffering in lung cancer victims. Together we can continue
to decrease lung cancer deaths.”
AATS is currently developing its next set of recommendations, including the AATS risk calculator, slated for release in 2014.