USPSTF Guidelines Identify More High-Risk Patients Who May Later Develop Lung Cancer

Background: Current U.S. Preventive Services Task Force (USPSTF) lung cancer screening guidelines emphasize pack-year smoking history, duration of cessation of smoking, along with age and general health (specifically, the ability to undergo treatment if cancer is found). Use of pack-year smoking history is based on historical precedent, but there is evidence that the duration of smoking is more strongly associated with development of lung cancer than pack-years, which represents smoking intensity. Current USPSTF recommendations may underestimate lung cancer risk in some minority ethnic and racial groups and, thereby, miss treatable cancers. Objective: To compare the use of pack-year smoking history versus smoking duration in identifying high-risk individuals for low-dose CT (LDCT) screening. Design: Analysis of 2 large cohort studies. Methods: The authors compared the eligibility for screening of 49,703 individuals with smoking history from the Southern Community Cohort Study (SCCS) more...