Screening for Lung Cancer: Moving Into a New Era
S'appuyant entre autres sur des études de modélisation, un groupe d'experts américains ("U.S. Preventive Services Task Force") met à jour ses recommandations sur le dépistage du cancer du poumon chez des adultes asymptomatiques âgés de 55 à 80 ans ayant une pratique tabagique ou ayant cessé de fumer dans les 15 dernières années
This issue of Annals includes the most recent U.S. Preventive Services Task Force (USPSTF) recommendations on screening for lung cancer (1), an important paper because of the findings and because lung cancer causes as many deaths in the United States as the next 3 leading types of cancer combined (all of which already have screening interventions). The USPSTF concluded that deaths due to lung cancer are significantly reduced by low-dose computed tomography (CT) screening in healthy individuals with an elevated risk for lung cancer (specifically adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years). The USPSTF emphasizes careful patient selection and not screening patients with lower risk or comorbid conditions that limit life expectancy or suitability for resection. The accuracy of image interpretation should be similar to that in the NLST (National Lung Screening Trial), and most false-positive results should be resolved without invasive procedures. The USPSTF advocates for screening in organized programs with a discussion of benefits and harms; smoking cessation counseling for active smokers; a standardized approach to scanning, image interpretation, and ensuring follow-up; adherence to quality standards; participation in a registry; and validation of whether broad implementation of CT screening achieves results similar to those of the NLST. In other words, the USPSTF recommends a structured screening process, not simply a scan...
Annals of Internal Medicine , éditorial en libre accès, 2012