Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology

Abstract

Lung cancer is the leading cause of cancer-related mortality in the United States and worldwide. Early detection of lung cancer is an important opportunity for decreasing mortality. Data support using low-dose computed tomography (LDCT) of the chest to screen select patients who are at high risk for lung cancer. Lung screening is covered under the Affordable Care Act for individuals with high-risk factors. The Centers for Medicare & Medicaid Services (CMS) covers annual screening LDCT for appropriate Medicare beneficiaries at high risk for lung cancer if they also receive counseling and participate in shared decision-making before screening. The complete version of the NCCN Guidelines for Lung Cancer Screening provides recommendations for initial and subsequent LDCT screening and provides more detail about LDCT screening. This manuscript focuses on identifying patients at high risk for lung cancer who are candidates for LDCT of the chest and on evaluating initial screening findings.

Different characteristics and survival in non‐small cell lung cancer patients with primary and acquired EGFR T790M mutation

“…As is shown in Supporting Information Table 2, the base characteristics of the two groups show no statistically significant differences, suggesting that there is no major selection bias. On the other hand, according to NCCN guidelines, osimertinib is recommended for patients with acquired EGFR T790M mutation . For primary EGFR T790M mutant patients, no recommendations were proposed.…”

“…Epidermal growth factor receptor (EGFR) accounts for most gene alternations, which can be detected in nonsmokers, female, adenocarcinomas, and East Asians . For advanced NSCLC patients who harbored EGFR mutation, first generation EGFR tyrosine kinase inhibitors (TKIs), including gefitinib, erlotinib, are the first line treatment recommended by National Comprehensive Cancer Network (NCCN) guidelines …”

Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening

“…The National Comprehensive Cancer Network (NCCN) recommends annual lung cancer screening according to the NLST criteria for adults who do not have additional risk factors for lung cancer (group 1). The NCCN does not specify a specific stopping age, stating that an adult undergoing screening should continue screening until they are no longer candidates for definitive treatment . The NCCN recommends that adults who have additional risk factors for lung cancer (group 2), such as personal history of other cancers or lung disease (chronic obstructive pulmonary disease and diffuse pulmonary fibrosis), family history of lung cancer, radon exposure, and occupational exposure to carcinogens that elevate their 5‐year risk above 1.3%, should begin screening at age 50 years if they have at least a ≥20‐pack‐year history.…”

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

“…The Centers for Medicare and Medicaid (CMS) covers lung cancer screening for Medicare beneficiaries according to the NLST criteria but will cover lung cancer screening until age 77 years . The National Comprehensive Cancer Network (NCCN) recommends annual lung cancer screening according to the NLST criteria for adults who do not have additional risk factors for lung cancer (group 1), although the NCCN does not have a stopping age, stating that an adult undergoing screening should continue screening until they are no longer candidates for definitive treatment . The NCCN recommends that adults who have additional risk factors for lung cancer (group 2), such as a personal history of other cancers or lung disease (chronic obstructive pulmonary disease and diffuse pulmonary fibrosis), a family history of lung cancer, radon exposure, and occupational exposure to carcinogens, that elevate their 5‐year risk above 1.3% should begin screening at age 50 years if they have a history of at least 20 pack‐years.…”

“…The NCCN recommends that adults who have additional risk factors for lung cancer (group 2), such as a personal history of other cancers or lung disease (chronic obstructive pulmonary disease and diffuse pulmonary fibrosis), a family history of lung cancer, radon exposure, and occupational exposure to carcinogens, that elevate their 5‐year risk above 1.3% should begin screening at age 50 years if they have a history of at least 20 pack‐years. Group 2 patients who are former smokers also should continue to undergo screening regardless of the time since they quit …”