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The American College of Chest Physicians has published a new clinical guideline on screening for lung cancer. The key recommendation is:
“For smokers and former smokers who are age 55 to 74 and who have smoked for 30 pack-years or more and either continue to smoke or have quit within the past 15 years, we suggest that annual screening with LDCT [low-dose computed tomography] should be offered . . . but only in settings that can deliver the comprehensive care provided to NLST [National Lung Screening Trial] participants.”
This cautious language reflects several points that the guideline addresses in detail. First, because the NLST is the only randomized trial that has shown a mortality benefit (JW Gen Med Jul 14 2011), the authors believe that…