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Lead-time bias — USMLE Step 3 MCQ

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HardPreventive Medicine, Epidemiology, BiostatisticsLead-time biasUSMLE Step 3

According to the current American Cancer Society guideline, a healthy 76-year-old with a 45-pack-year history who quit smoking 16 years ago remains willing and able to undergo curative treatment. What screening plan is recommended?

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Correct answer: C — Continue annual low-dose CT through the eligible age range

The best answer is “Continue annual low-dose CT through the eligible age range”. The American Cancer Society recommends annual low-dose CT for people aged 50–80 years with at least 20 pack-years who currently smoke or formerly smoked, provided health and treatment eligibility remain appropriate. Unlike the USPSTF recommendation, the current ACS guideline does not impose a 15-year quit-time cutoff; naming the authority is therefore essential.

Reference: American Cancer Society Lung Cancer Screening Guideline: https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/lung-cancer-screening-guidelines.html