Study: Smokers Who Quit Early May Not Qualify For Lung Cancer Screenings

A decrease in smoking rates may increase deaths from lung cancer, according to a new study. The problem is that many former smokers don’t qualify for lung scans that can detect the cancer early when it’s most curable, says a New York thoracic surgeon.

Current guidelines recommend annual low-dose CT lung screening for people ages 55 to 80 who have smoked one pack a day for 30 years, and who are smoking now or have kicked the habit within the last 15 years. The criteria has remained the same despite the decline in smoking rates in the U.S., say researchers from the Mayo Clinic Cancer Center who conducted the study.

“The guidelines need to be broader,” said Lawrence Glassman, MD, vice chairman of Thoracic Surgery for the North Shore-LIJ Health System. “The epidemiological link between smoking and lung cancer is unquestionable. Screening should be more widely applied. Many younger patients with major tobacco exposure, and those who have quit, are still at risk.”

During the study period 1984 to 2011, the percentage of lung cancer patients who would have met the screening guidelines fell significantly: from 56.8% in 1984-1990 to 43.3% in 2005-2011. The proportion of men who would have been eligible decreased from 60% to 49.7%, while the percentage of women dropped from 52.3% to 36.6%.

According to the researchers, the percentage of lung cancer patients who smoked at least a pack a day for 30 years declined over the study period while the proportion of cancer patients who had quit for more than 15 years rose.

“The effectiveness of the screening is documented, those at increased risk need to be screened, even if they have stopped in the past,” said Dr. Glassman.

More than 150,000 Americans die from lung cancer each year, according to the American Lung Association. It’s the leading cause of cancer death in the United States.

The screening guidelines are used by doctors and insurance companies to recommend and pay for the CT scans.

The study was published Feb. 24 in the journal of the American Medical Association.