Screening for Lung Cancer: U.S. Preventive Services Task Force Recommendation Statement

TLDR

The 2023 USPSTF recommendation updates the 2004 guidance on lung cancer screening. The USPSTF reviewed evidence on low‑dose CT, chest radiography, and sputum cytology for asymptomatic smokers, modeled optimal age, interval, and strategy, and defined the target population as adults 55–80 with a 30‑pack‑year history who currently smoke or quit within 15 years. It recommends annual low‑dose CT screening for those adults and advises discontinuation after 15 years of smoking cessation or when life expectancy or surgical candidacy is limited. The recommendation is graded as B.

Abstract

Description: Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for lung cancer. Methods: The USPSTF reviewed the evidence on the efficacy of low-dose computed tomography, chest radiography, and sputum cytologic evaluation for lung cancer screening in asymptomatic persons who are at average or high risk for lung cancer (current or former smokers) and the benefits and harms of these screening tests and of surgical resection of early-stage non–small cell lung cancer. The USPSTF also commissioned modeling studies to provide information about the optimum age at which to begin and end screening, the optimum screening interval, and the relative benefits and harms of different screening strategies. Population: This recommendation applies to asymptomatic 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. Recommendation: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography in 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. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. (B recommendation)