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December 2023 | George M. Pikler, M.D., Ph.D., FACP

Lung Cancer Screening for Former Smokers

The American Cancer Society (ACS) has released new lung cancer screening guidelines with an annual low dose computed tomography (CT) for anyone aged 50 to 80 who was formerly a long-term or heavy smoker, a recommendation that could affect millions of Americans.

The new guideline applies to anyone who smoked for 20 so-called pack-years, for example, a pack a day for 20 years or two packs a day for 10 years. According to ACS’s Chief Scientific Officer Dr. William Dahut “a lot of times people don’t consider themselves a smoker because they haven’t smoked in 10, 15 or 20 years.” If you have a significant smoking history and quit when you were 28 years old and now you’re 55, he said, “you definitely should be screened.”

Previously, the ACS called for screening only for long-time or heavy smokers who had given up cigarettes less than 15 years earlier. The new guidance says the need for screening should no longer be determined in part by how much time has passed since smokers quit.

The lung cancer risk to former smokers does decrease over time when compared with similar people who continue to smoke. When compared with never-smokers, however, their risks remain three times greater even when 20 or 30 years have passed since they quit.

The update also expands the organization’s recommended age range for lung cancer screening to 50 to 80 years, from the previous range of 55 to 74 years, and decreases the number of required pack-years from 30 to 20.

While ACS guidelines are highly regarded by the medical community, whether insurance companies will pay for screening in longer-term former smokers is not yet known, the ACS researchers acknowledged. The U.S. Medicare health plan for Americans aged 65 and older generally follows recommendations of the government-backed U.S. Preventive Services Task Force, which still calls for yearly lung cancer screening of former smokers who have quit within the past 15 years, they noted.

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Erica

Erica Cross, PA

PA

Erica is a board certified Physician Assistant. She obtained her Master’s degree in Physician Assistant studies from Our Lady of the Lake College in Baton Rouge, LA. She began practicing in 2011 and has worked clinically in Orthopedics and Dermatology. The majority of her career has been spent in a Dermatology practice where she assisted in Mohs surgery, treating various types of skin cancer. She also teaches in the medical simulation department at the University of South Alabama and enjoys every aspect of medical education.