News | Lung Cancer | March 07, 2016

Canadian Task Force Issues New Lung Cancer Screening Guideline

High-risk patients can receive CT screening up to three times per year; task force recommends against any chest X-ray screening

Canadian task force, lung cancer screening guideline, CMAJ, low-dose CT

March 7, 2016 — Adults aged 55-74 years who are at high risk of lung cancer should be screened annually up to three times using low-dose computed tomography (CT), according to a new guideline from the Canadian Task Force on Preventive Health Care (CTFPHC). The guideline was published in the Canadian Medical Association Journal (CMAJ).

Lung cancer is the most common cancer in Canada and the number one cause of deaths from cancer. In 2015, about 26,600 Canadians were diagnosed with lung cancer, and almost 21,000 died from it. Most cases of lung cancer, about 85 percent, are linked to tobacco smoking.

"Screening for lung cancer aims to detect disease at an earlier stage, when it may respond better to treatment and be less likely to cause serious illness or death," stated Gabriela Lewin, M.D., chair of the CTFPHC guideline working group.

This guideline incorporates new evidence, including results from a large randomized controlled trial comparing low-dose CT with chest X-rays, and balances the benefits of early detection with the harms of overdiagnosis and invasive follow-up testing. It replaces the 2003 guideline from the CTFPHC.

Key recommendations from the guideline include:

  • Adults aged 55-74 years who are at high risk of lung cancer (i.e., current or former smokers [have quit within 15 years] with at least a 30 pack-year history or more) should be screened annually up to three consecutive times using low-dose CT;
  • Screening must be conducted in a healthcare setting with expertise in diagnosing and treating lung cancer;
  • For all other adults, the task force recommends not screening for lung cancer, regardless of age or smoking history; and
  • The task force recommends not using chest X-rays to screen for lung cancer.

These recommendations do not apply to people with a family history of lung cancer or who have symptoms suggestive of lung cancer. For people with other risk factors for lung cancer, such as radon exposure, exposure to second-hand smoke and previous radiation to the chest, it is unknown whether they would benefit from screening with low-dose CT.

The task force recommends that physicians should have a conversation about screening preferences with patients at high risk of lung cancer, considering age, health status and ability to benefit from potential treatment.

"People who place a higher value on a potential mortality benefit and are less concerned with the harms associated with screening (e.g., high false-positive rate, complications from follow-up testing) will be more likely to choose screening, whereas those more concerned with the harms and small mortality benefit may choose not to be screened," stated Lewin.

There are currently no organized screening programs for lung cancer in the Canadian provinces or territories.

"Smoking remains the primary risk factor for lung cancer; therefore, interventions to promote smoking cessation (which have benefits beyond decreasing the risk of lung cancer) should be incorporated into any screening program aimed at reducing lung cancer morbidity and mortality," write the task force members.

Although these new recommendations are similar to other Canadian and international guidelines, the task force's recommendation to screen annually over three consecutive years is more conservative than the others, which recommend ongoing annual or biennial screening.

For more information: www.canadiantaskforce.ca

Related Content

SimonMed Deploys ClearRead CT Enterprise Wide
News | Computer-Aided Detection Software | September 17, 2018
September 17, 2018 — National outpatient physician radiology group SimonMed Imaging has selected Riverain Technologie
Siemens Healthineers Announces First U.S. Install of Somatom go.Top CT
News | Computed Tomography (CT) | September 17, 2018
September 17, 2018 — The Ohio State University Wexner Medical Center in Columbus recently became the first healthcare
Veye Chest version 2
News | Lung Cancer | September 11, 2018
Aidence, an Amsterdam-based medical AI company, announced that Veye Chest version 2, a class IIa medical device, has
The CT scanner might not come with protocols that are adequate for each hospital situation, so at Phoenix Children’s Hospital they designed their own protocols, said Dianna Bardo, M.D., director of body MR and co-director of the 3D Innovation Lab at Phoenix Children’s.

The CT scanner might not come with protocols that are adequate for each hospital situation, so at Phoenix Children’s Hospital they designed their own protocols, said Dianna Bardo, M.D., director of body MR and co-director of the 3D Innovation Lab at Phoenix Children’s.

Sponsored Content | Case Study | Radiation Dose Management | September 07, 2018
Radiation dose management is central to child patient safety. Medical imaging plays an increasing role in the accurate...
Carestream Releases Second-Generation Metal Artifact Reduction Software for OnSight 3D Extremity System
Technology | Computed Tomography (CT) | September 06, 2018
Carestream Health has started shipping a new software version for its Carestream OnSight 3D Extremity System that...

Image courtesy of Siemens Healthineers

Feature | CT Angiography (CTA) | September 06, 2018 | Dave Fornell
There have been a few big, recent advancements in cardiac computed tomography angiography (CCTA) imaging technology....
Key Patient Preparations for a CT Scan
News | Computed Tomography (CT) | September 05, 2018
The Center for Diagnostic Imaging (CDI) in Miami recently released a list of important preparations patients should...
iSchemaView RAPID Technology Now Installed in More Than 500 Stroke Centers
News | Neuro Imaging | August 27, 2018
iSchemaView announced that more than 575 stroke centers in 22 countries have selected the RAPID advanced imaging...
RSNA Announces Pneumonia Detection Machine Learning Challenge
News | Artificial Intelligence | August 27, 2018
The Radiological Society of North America (RSNA) has launched its second annual machine learning challenge. The RSNA...
Doctor-Patient Discussions Neglect Potential Harms of Lung Cancer Screening
News | Lung Cancer | August 15, 2018
August 15, 2018 — Although national guidelines advise doctors to discuss the benefits and harms of...