Early detection of lung cancer through low-dose computed tomography screening is one of the most promising strategies to reduce lung cancer mortality among high-risk individuals. The U.S.
Preventative Services Task Force currently recommends annual for adults aged 50 to 80, who have at least a 20-pack-year smoking history (one pack year is the equivalent of smoking an average of 20 cigarettes per day for a year), and who either currently smoke or quit smoking within the last 15 years. However, the use of pack-year smoking history as a measure for lung cancer risk has been criticized on the grounds that it incorrectly assumes that smoking intensity and duration have equal importance in determining lung cancer risk. Previous studies have shown that smoking duration is more strongly associated with lung cancer risk compared to smoking intensity.
As a result, the use of pack-year smoking history to select individuals for screening may exclude many individuals at high risk for lung cancer by underestimating lung cancer risk among those who smoke less intensely (i.e., fewer cigarettes per day), such as individuals from racial and ethnic minority groups.
In a recent study in the shows that a new proposed guideline—that is the same as the USPSTF guideline but replaces the 20-pack-year requirement with a 20-year smoking duration requirement—increases the proportion of lung cancer patients who would have qualified for screening and eliminates the racial disparity in screening eligi.