U.S. Preventative Services Task Force Issues New Recommendation for Lung Cancer Screening
The United States Preventive Services Task Force (USPSTF) has issued 2021 guidelines for lung cancer screening. The last change made to these guidelines was in 2013.
What is a screening test?
A screening test is for people at risk for a condition but who have not yet been diagnosed. Screening tests attempt to catch a condition in its early stages. Examples of screening tests include colonoscopy for colon cancer and Pap smear for cervical cancer.
Lung cancer screening
In lung cancer, the common screening test is a computed tomography (CT) scan. A CT scan is similar to an X-ray. However, CT scans create a 3-dimensional image of the body and provide more detail. Because of this, CT scans expose a person to more radiation. There is a lower-radiation version of CT called a low-dose computed tomography (LDCT) scan. This is used in lung cancer screening.
If a person’s lung cancer is detected earlier, their chance of successful treatment is higher. For example, a stage 1 lung cancer found with screening may be cured with surgery or radiation. However, if a person was not screened and their cancer was found later on, the chances the cancer has spread are higher. More advanced cancers are harder to treat.
How have the recommendations changed?
The 2021 recommendations encourage yearly LDCT scans in people between the ages of 50 and 80 years old who have smoked 20 pack-years. This includes people who have quit smoking in the last 15 years. The guidelines are not meant for people who have quit smoking more than 15 years ago.1,2
One pack-year means smoking 1 pack of cigarettes a day for a year. Someone with a 20 pack-year smoking history has smoked a pack a day for 20 years. It can also mean smoking 2 packs a day for 10 years or any other combination that averages to 20 pack-years.1,2
This is different from the 2013 guidelines in age and smoking history. The 2013 guidelines included people between the ages of 55 and 80 years old. Also, the older guidelines were for people with a 30 pack-year history instead of 20 pack-years.1,2
Why are these changes important?
The 2021 guidelines will include younger people and people with less of a smoking history. The number of people eligible for screening will almost double.1-3
This change is especially important for women and minority groups. Both of these groups tend to smoke less than white men, who make up a large percentage of those previously eligible for screening.1-3
Although women and Black people may smoke less on average, they are still at risk. Research has suggested that Black people specifically have a higher risk of developing lung cancer than white people. This is true even when they have less of a smoking history.1-3
What are the risks of these changes?
As with any medical test, there are risks of increased screening. Although experts say the chances are low, it is possible to have false-positive screening tests. This may mean finding something that is not cancerous but looks like a potential cancer. Examples include benign lung nodules and infections, among others.1,2
Positive screening tests often lead to more scans, biopsies, or even surgery. These can be invasive, risky, and costly. Additionally, potentially having cancer can lead to anxiety and distress. Further tests are helpful if a person does have cancer. However, all of these efforts and stress may be unnecessary if the screening test was a false-positive.1,2
Radiation exposure can also cause lung cancer. Some experts have wondered if yearly CT scans actually increase risk. However, the amount of radiation in LDCT is thought to be even lower than the background radiation a person is exposed to each year. While there is still a risk that yearly CT scans could lead to cancer, the estimated number of these cases is still less than the potential deaths prevented.1,2
In all cases, a person and their doctor can discuss the personal risk of lung cancer, as well as the risks and benefits of screening.
What is the U.S. Preventative Services Task Force?
The USPSTF is a group of independent medical experts. They review data and make decisions on preventive medicine and treatment options. They recommend screening tests, counseling topics, and more. They grade their recommendations A, B, C, D, and I (insufficient) based on the data used and how confident they are in the potential benefits. A and B are the strongest grades.1,2
The 2021 lung cancer screening guidelines have a grade B recommendation.1,2
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Timu ya Kazi ya Huduma za Kuzuia ya Marekani (USPSTF) imetoa miongozo ya 2021 kwa ajili ya uchunguzi wa saratani ya mapafu. Mabadiliko ya mwisho yaliyofanywa kwa miongozo hii yalikuwa katika 2013. Uchunguzi wa uchunguzi ni nini? Uchunguzi wa uchunguzi ni kwa ajili ya watu walio katika hatari ya ugonjwa lakini ambao bado hawajatambuliwa. Majaribio ya uchunguzi hujaribu kugundua hali fulani katika hatua zake za mapema. Mifano ya vipimo vya uchunguzi ni pamoja na colonoscopy kwa kansa ya utumbo na Pap smear kwa kansa ya shingo ya tumbo la uzazi. Uchunguzi wa saratani ya mapafu Katika saratani ya mapafu, mtihani wa kawaida wa uchunguzi ni uchunguzi wa tomografia (CT). Uchunguzi wa CT ni sawa na uchunguzi wa X-ray. CT scan ni njia ya kuunda picha ya mwili ya 3D na kutoa maelezo zaidi. Kwa sababu hiyo, uchunguzi wa CT humfanya mtu awe na mnururisho mwingi zaidi. Kuna aina ya CT inayoweza kuondoa mionzi ya chini inayoitwa low-dose computed tomography (LDCT). Hii hutumiwa katika uchunguzi wa kansa ya mapafu. Ikiwa kansa ya mapafu ya mtu hugunduliwa mapema, uwezekano wake wa kutibiwa kwa mafanikio ni mkubwa zaidi. Kwa mfano, kansa ya mapafu ya hatua ya kwanza inayopatikana kwa uchunguzi wa uchunguzi yaweza kutibiwa kwa upasuaji au mionzi. Hata hivyo, ikiwa mtu hakuchunguzwa na kansa yake ilipatikana baadaye, uwezekano wa kansa kuenea ni mkubwa zaidi. Kansa zilizo katika hatua ya juu zaidi ni vigumu kutibu. Mapendekezo hayo yamebadilikaje? Kwa mujibu wa mapendekezo ya mwaka huu, watu wenye umri wa miaka 50 hadi 80 ambao wamevuta sigareti kwa miaka 20 wanapaswa kuchunguzwa kila mwaka. Hii inahusisha watu ambao wameacha kuvuta sigara katika miaka 15 iliyopita. Miongozo hii haikusudiwi kwa watu ambao wameacha kuvuta sigara zaidi ya miaka 15 iliyopita. Mtu mwenye historia ya kuvuta sigareti ya pakiti 20 ya miaka 20 amevuta pakiti moja kwa siku kwa miaka 20. "Hii inaweza pia kumaanisha kuvuta pakiti mbili za sigara kwa siku kwa miaka kumi au mchanganyiko mwingine wowote ambao kwa wastani ni pakiti 20 za miaka, ""alisema." Miongozo ya mwaka 2013 ilihusisha watu wenye umri wa miaka 55 hadi 80. Kwa mfano, miongozo ya zamani ilitumiwa kwa watu wenye historia ya pakiti 30 badala ya pakiti 20. Miongozo ya 2021 itajumuisha vijana na watu wenye historia ndogo ya kuvuta sigara. Idadi ya watu wanaostahili kupimwa itakuwa karibu mara mbili. Wanaume wazungu wanavuta sigareti mara chache kuliko wanaume wazungu, ambao wana asilimia kubwa ya wale waliostahili kupimwa. Utafiti unaonyesha kuwa watu weusi wana hatari kubwa ya kupata kansa ya mapafu kuliko wazungu. Hii ni kweli hata wakati wao wana historia ya kuvuta sigara kidogo. Kama ilivyo na uchunguzi wowote wa kitiba, kuna hatari ya uchunguzi wa ziada. Ingawa wataalamu wanasema uwezekano ni mdogo, inawezekana kufanya vipimo vya uchunguzi vyenye matokeo mabaya. Hilo laweza kumaanisha kupata kitu kisicho cha kansa lakini kinachoonekana kuwa kansa ya uwezekano. Mifano ya ugonjwa huu ni kama vile nodules ya mapafu na maambukizi, na mara nyingi matokeo mazuri ya uchunguzi wa uchunguzi husababisha uchunguzi zaidi, biopsy, au hata upasuaji. Hizi zaweza kuwa zenye kuingilia, zenye hatari, na zenye gharama kubwa. Kwa kuongezea, uwezekano wa kuwa na kansa waweza kusababisha wasiwasi na huzuni. Uchunguzi zaidi ni wenye kusaidia ikiwa mtu ana kansa. Hata hivyo, jitihada hizi zote na mkazo inaweza kuwa si muhimu kama uchunguzi wa uchunguzi ilikuwa uongo-chanya.1,2 Mwangaza wa mionzi pia inaweza kusababisha kansa ya mapafu. Wataalamu fulani wamejiuliza ikiwa uchunguzi wa CT unaofanywa kila mwaka kwa kweli huongeza hatari. Hata hivyo, kiasi cha mnururisho katika LDCT hufikiriwa kuwa hata chini ya mnururisho wa nyuma mtu hufunuliwa kila mwaka. Ingawa kuna hatari ya kuwa na CT scan ya kila mwaka inaweza kusababisha kansa, idadi ya takwimu ya kesi hizi bado ni chini ya vifo vya uwezekano wa kuzuia.1,2 Katika kesi zote, mtu na daktari wake wanaweza kujadili hatari ya kibinafsi ya saratani ya mapafu, pamoja na hatari na faida za uchunguzi. U.S. Preventive Services Task Force (USPSTF) ni shirika la Marekani linalohusika katika utunzaji wa afya ya watu. USPSTF ni kikundi cha wataalamu wa matibabu huru. Wao hukagua habari na kufanya maamuzi kuhusu tiba ya kuzuia na chaguzi za matibabu. Wao hupendekeza vipimo vya uchunguzi, mashauriano, na mengi zaidi. "Wanachagua ""A,"" ""B,"" ""C,"" ""D,"" na ""I"" kulingana na data na jinsi wanavyoamini faida zinazowezekana." "A na B ni viwango vya juu zaidi.Miongozo ya uchunguzi wa saratani ya mapafu ya 2021 ina mapendekezo ya ""B"" ya kiwango cha juu.Umechukua utafiti wetu wa ""In America"" bado?"