Lung cancer screening — ABIM Board MCQ

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EasyPulmonary/Critical CareLung cancer screeningABIM Board

A 60-year-old woman with a 35 pack-year smoking history quit smoking 8 years ago. She has no hemoptysis, weight loss, or other symptoms suggestive of lung cancer. She is in good health and would be willing to undergo curative treatment if lung cancer were detected. Which of the following screening strategies should be recommended?

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Correct answer: A — Annual low-dose CT of the chest

Annual low-dose CT of the chest is recommended. The USPSTF recommends annual lung cancer screening with low-dose CT for asymptomatic adults aged 50–80 years who have at least a 20 pack-year smoking history and currently smoke or quit within the past 15 years, provided their health permits potentially curative treatment. This patient is 60 years old, has a 35 pack-year history, and quit only 8 years ago, so she qualifies. Screening is not withheld merely because she stopped smoking; it is discontinued after 15 years of abstinence or when health substantially limits life expectancy or curative treatment. Chest radiography and sputum cytology have not demonstrated sufficient screening benefit. PET/CT is not a screening test and would expose her to unnecessary radiation and false-positive findings.

Reference: US Preventive Services Task Force. Lung Cancer: Screening, Recommendation Statement, 2021. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening