Age-Based Screening for Lung Cancer Surveillance in the US

What proportion of patients with lung cancer meet US Preventive Services Task Force (USPSTF) screening criteria, and would age-based screening improve detection and be cost-effective?In a cohort of 997 patients with lung cancer, only 35.1% met USPSTF criteria; noneligible patients had better survival. Expanding criteria to ages 40 to 85 years and 10 or more pack-years increased the detection rate to only 62.1%, whereas universal age-based screening (40-85 years) detected 93.9% of cancers, preventing at least 26 124 deaths annually at $101 000 per life saved vs $890 000 for breast and $920 000 for colorectal screening.These findings suggest that current screening guidelines miss most patients with lung cancer, and age-based screening could improve detection and cost-effectiveness while reducing disparities.

Corresponding Author: Ankit Bharat, MD, Division of Thoracic Surgery, Canning Thoracic Institute, Northwestern University Feinberg School of Medicine, 676 N St Clair St, Ste 650, Chicago, IL 60611 (ankit.bharat@nm.org).

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