CHEST Guidelines-Screening for Lung Cancer

Screening for Lung Cancer

Pdf Summary

The CHEST Guideline and Expert Panel Report, led by Dr. Peter J. Mazzone, updates recommendations for lung cancer screening with low-dose CT (LDCT) based on new evidence. The guidelines affirm that LDCT screening reduces lung cancer mortality by about 19% on average, with significant reductions observed among both men and women. Screening is recommended for asymptomatic individuals aged 55 to 77 who have smoked at least 30 pack-years and either continue to smoke or quit within the past 15 years. A weaker recommendation extends screening to those aged 50 to 80 with a 20 pack-year smoking history. Screening eligibility may also include validated clinical predictions for high net benefits from screening, calculated using risk assessment tools.<br /><br />Important components of an LDCT screening program include careful selection of individuals based on age, smoking history, and potential to benefit, as well as structured reporting and standardized nodule management to optimize outcomes. Programs should provide effective counseling and shared decision-making, addressing potential harms such as radiation exposure, overtreatment, complications from biopsies, and psychological impacts.<br /><br />To ensure high-quality screening, programs should include multidisciplinary teams and strategies to support annual screening compliance, integrate smoking cessation interventions, and collect data for quality improvement. Specific recommendations include adopting structured reporting systems like LungRADS to guide screening result interpretation, and following protocols to limit radiation exposure.<br /><br />Overall, the guidelines aim to balance the benefits of early detection and treatment of lung cancer with the potential screening harms, aiming to ensure that LDCT screening is offered to populations most likely to benefit while mitigating possible adverse outcomes.

Keywords

lung cancer screening

low-dose CT

LDCT

guidelines

smoking history

risk assessment

nodule management

radiation exposure

multidisciplinary teams

LungRADS