RSNA/ACR Support USPSTF Recommendation on CT Lung Cancer Screening but Wait to Issue Own Guidelines
In a statement of support for the United States Preventive Services Task Force (USPSTF) draft recommendation in favor of CT lung cancer screening of high-risk individuals, the RSNA and ACR also stated that that the ACR is working on guidelines and practice standards, but for now, providers and patients should follow the National Comprehensive Cancer Network (NCCN) guideline for lung cancer screening. The USPSTF grade B draft recommendation applies only to patients who match the criteria of those in the landmark National Lung Screening Trial (NLST) that found that screening for lung cancer with CT imaging reduces deaths from lung cancer by 20 percent. Those criteria are being 55 through 79 years old and having a 30-pack-year or greater history of smoking. There is concern that in the absence of strict guidelines and practice standards, the test could be marketed more broadly to patients who do not match the criteria and do not fully understand the risk the test poses, both from radiation and from false positives that require more invasive additional testing with greater risk of harm. The ACR and RSNA alluded to many of these risks in their joint press release supporting the USPSTF recommendation. “The RSNA and the ACR look forward to working with the U.S. Department of Health and Human Services, the National Cancer Institute, Congress and other key stakeholders in taking the necessary steps to create a sustainable and effective CT lung cancer screening process,” the press release stated. The ACR also promised to provide as much guidance as it could to providers and individuals as it finalized its own official practice guidelines and standards, but referred to NCCN guidelines as the ones to use for now. A free registration is required for physicians to view the NCCN’s document "Lung Cancer Screening".