Which People Who Smoke Should Undergo Lung Cancer Screening?

Smoking is known to cause most cases of the cancer that is among the most common worldwide and causes the greatest number of deaths, namely lung cancer—90% of cases. Indeed, before smoking became widespread, lung cancerwas a rare cancer. The only way to reduce lung cancer incidence appears to be reducing tobacco and tobacco product use, while the way to improve disease outcomes is early diagnosis. Although lung cancer screening is not yet widespread, follow-up with radiological imaging is recommended to enable early diagnosis in people who have smoked for many years. While the scope of screeningfor colorectal or breast cancer is much clearer, researchers are still investigating who should begin lung cancer screening for early detection, at what age, and how frequently. Annals of Internal Medicinepublished a report analyzing nine different risk prediction models based on people in the United States population, showing how long-term smokers should be screened .

This study aimed to evaluate the performance of these 9 models used for lung cancer screening. The models were: the Bach model; the Spitz model; the Liverpool Lung Project (LLP9) model; the LLP Incidence Risk Model (LLPi); the Hoggart model; the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Model 2012 (PLCOM2012); the Pittsburgh Predictor; the Lung Cancer Risk Assessment Tool (LCRAT); and the Lung Cancer Death Risk Assessment Tool (LCDRAT). Data from approximately 400 thousand people who smoked were evaluated to measure model performance.

According to the findings, four risk models—the Bach model, PLCOM2012, LCRAT, and LCDRAT—provided more accurate results for risk prediction and screening than the others.

Lung Cancer Screening Can Save the Lives of People Who Smoke

• Lung cancer screening is critically important and can save the lives of people who smoke.
• For now, the best available evidence for lung cancer screening comes from prospective (forward-looking) research recommending screening with low-dose chest computed tomography in people over 55 with a smoking history of at least 15 years, namely clinical trials.

In conclusion, although many studies seek to predict lung cancer risk in people who smoke, the currently accepted recommendation is as follows:

People with no symptoms suggesting lung cancer (asymptomatic), aged 55-77, who have smoked for at least 30 years—even if they quit within the last 15 years—should undergo annual screening with low-radiation-dose chest computed tomography (CT).

To reduce cancer-related deaths, it is important to perform early detection screening tests. However, reassuring low-dose chest CT results in people at high risk because of heavy tobacco use do not mean that their existing risk has decreased. Avoiding smoking and other tobacco products, avoiding secondhand smoke , and avoiding radon gas and other chemicals such as asbestos are all important. Remember that avoiding all factors that increase lung cancer risk is far more important for cancer prevention. 

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