In a study of nearly 1,000 consecutive patients treated for lung cancer at Northwestern Medicine, researchers discovered only 35% would have qualified for screening according to the U.S. Preventive Services Task Force (USPSTF) screening criteria. The two-thirds of patients who would have been excluded were disproportionately women and never-smokers.
Currently, USPSTF recommends annual lung cancer screenings for adults ages 50-80 who have a 20 pack-year smoking history (the equivalent of one pack of cigarettes a day for 20 years, or two packs a day for 10 years) and currently smoke or have quit within the past 15 years – a narrow window that excludes many vulnerable individuals.
In the new study, published in JAMA Network Open, Northwestern Medicine researchers recommend expanding the universal age-based screening to ages 40-85. They estimate this would detect 94% of lung cancers, preventing more than 26,000 extra deaths annually. The research also demonstrates that such screening would be remarkably cost-effective, with the minimal risks from radiation exposure or biopsies far outweighed by the potential to save lives.
“We moved to universal age-based screening for breast and colon cancer with tremendous success, and we need to move to the same approach for lung cancer. Chest screening offers something unique — with one low-dose scan, we can assess lungs, heart and bones comprehensively. This baseline scan becomes invaluable for monitoring their health over time,” said Dr. Ankit Bharat, professor of thoracic surgery at Northwestern University Feinberg School of Medicine and executive director of the Northwestern Medicine Canning Thoracic Institute.
Lung cancer remains America’s deadliest cancer, claiming more lives than breast, colon and prostate cancers combined, accounting for one in every five cancer deaths among both men and women. The disease is particularly insidious: Nearly 80% of cases aren’t discovered until they’ve reached advanced stages, largely because symptoms rarely appear until it’s too late. The widespread misconception that only smokers develop lung cancer, combined with limited screening access for those without tobacco history, contributes to these devastating statistics. Researchers at the Canning Thoracic Institute predict that a universal age-based screening (40-85) could enhance detection, improve cost-effectiveness and address health inequities.
Providing low-dose CT screening to all eligible adults
In response to these findings, Northwestern Medicine has launched the Lung Health Center at the Canning Thoracic Institute to detect lung, heart and bone conditions earlier. The center, supported by a generous gift from John and Rita Canning, will encourage lung cancer screening for Northwestern Medicine patients and conduct studies to evaluate low-dose CT screening with necessary assessments in patients who might not qualify for lung cancer screening. In addition, scans from all patients will be evaluated for their ability to detect early pulmonary fibrosis, post-COVID lung damage, cardiovascular disease, osteoporosis and other conditions affecting millions of Americans. The results of these screenings will be studied and published to inform changes to existing guidelines.
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