Current USPSTF Screening Guidelines Miss Many Patients With Lung Cancer

TUESDAY, Dec. 2, 2025 (HealthDay News) -- Current U.S. Preventive Services Task Force (USPSTF) lung cancer screening guidelines miss about two-thirds of patients with lung cancer, according to a study published online Nov. 20 in JAMA Network Open.Hee Chul Yang, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the proportion, clinical characteristics, and survival of patients with lung cancer who meet or are excluded from USPSTF criteria. Patients with lung cancer diagnosed from 2018 to 2023 were analyzed and followed up through 2024. Patients were stratified by 2021 USPSTF eligibility (age 50 to 80 years, 20 or more pack-years, and current smoker or quit less than 15 years prior).The researchers found that 350 of the 997 patients (35.1 percent) met the USPSTF criteria. More women, Asian patients, and never-smokers were included in the nonguideline group; compared with the guideline group, the nonguideline group had more adenocarcinoma diagnoses (72 versus 55 percent) and had better overall survival (9.5 versus 4.4 years; hazard ratio, 0.67). Detection was increased to 62.1 percent (619 of 997 patients) by expanding criteria to age 40 to 85 years, 10 or more pack-years, and no cessation limit. A modeled age-based screening (40 to 85 years) captured 93.9 percent of cases and would avert 26,124 deaths annually, with a cost of $101,000 per life saved compared with $890,000 and $920,000 for breast cancer and colorectal cancer screening, respectively. Robust findings were confirmed across all parameter ranges in a sensitivity analysis, with 98.7 percent probability of superior cost-effectiveness."Policy revisions should expand eligibility, address nontobacco risks, and mitigate implementation barriers to ensure equitable early detection," the authors write.Several authors disclosed ties to the pharmaceutical and medical device industries; one author served as an expert witness.Abstract/Full Text.Sign up for our weekly HealthDay newsletter