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

New Lung Ambition Alliance Aims to Double Five-year Lung Cancer Survival by 2025
News | Lung Cancer | July 17, 2019
The International Association for the Study of Lung Cancer (IASLC), Guardant Health, the Global Lung Cancer Coalition (...
Example of an intentionally truncated CT image

Figure 1: Example of an intentionally truncated CT image. The truncation percentage was calculated as the ratio of the patient border touching the field of view to the total patient border (red/(read+blue)). Image courtesy of Qaelum.

Feature | Radiation Dose Management | July 15, 2019 | Niki Fitousi, Ph.D., and An Dedulle
One of the main benefits of a radiation dose management system is the possibility to automatically generate alerts when...
Routine scan of abdomen pelvis taken with the UW-Madison’s Revolution 256 CT scanner using the FDA-cleared reconstruction algorithm, called TrueFidelity.

Routine scan of abdomen pelvis taken with the UW-Madison’s Revolution 256 CT scanner using the FDA-cleared reconstruction algorithm, called TrueFidelity. UW-Madison was the first site in the U.S. to get this technology. Its use is now being integrated into UW CT protocols. Image courtesy of Timothy P. Szczykutowicz

Feature | Computed Tomography (CT) | July 12, 2019 | By Greg Freiherr
When providers develop their own imaging protocols, they are wasting time and money, according to...
Mednax National Cardiac Centers of Excellence Program Highlighted at SCCT 2019
News | CT Angiography (CTA) | July 11, 2019
Mednax Inc. and Mednax Radiology Solutions announced that Chief Medical Officer Ricardo C. Cury, M.D., FSCCT, will...
Achenbach to Receive Inaugural 2019 Stephan Achenbach Pioneer Award in Cardiovascular CT
News | Cardiac Imaging | July 10, 2019
The Society of Cardiovascular Computed Tomography (SCCT) will present Stephan Achenbach, M.D., FSCCT with the inaugural...
Researchers Use Artificial Intelligence to Deliver Personalized Radiation Therapy
News | Radiation Therapy | July 09, 2019
New Cleveland Clinic-led research shows that artificial intelligence (AI) can use medical scans and health records to...
Jonathon Leipsic Awarded 2019 DeHaan Award for Innovation in Cardiology
News | Cardiac Imaging | July 08, 2019
Jonathon A. Leipsic, M.D., FSCCT, is the recipient of the 2019 DeHaan Award for Innovation in Cardiology, announced by...
vRad Presents AI Model to Assess Probability of Aortic Dissection
News | Artificial Intelligence | July 01, 2019
vRad (Virtual Radiologic), a Mednax company recently made a scientific presentation, “Screening for Aortic Dissection...
ClariPi Gets FDA Clearance for AI-powered CT Image Denoising Solution
Technology | Computed Tomography (CT) | June 24, 2019
Artificial intelligence (AI) imaging solution form ClariPi Inc. has received U.S. Food and Drug Administration (FDA)...
Third FDA Clearance Announced for Zebra-Med's AI Solution for Brain Bleed Alerts
Technology | Artificial Intelligence | June 19, 2019
Zebra Medical Vision announced it has received its third U.S. Food and Drug Administration (FDA) 510(k) clearance for...