Lung Cancer Screening: Is There a Better Way to Select Patients?

Eligibility for lung cancer screening in the United States is based solely on age and smoking history, but multiple studies have shown that a more personalized risk assessment — incorporating other known risk factors — might better identify patients who could benefit from screening (see Figure 1).

In the latest such study, researchers in Germany compared the performance of the Nelson criteria — which are similar to the U.S. criteria — against a previously validated risk calculator (PLCOm2012) that takes into account not only age and smoking history but also race, education, personal and family history of cancer, body-mass index, and chronic obstructive pulmonary disease. The study involved 5000 individuals who met the Nelson criteria or were at elevated risk for lung cancer according to the risk calculator (6-year risk, ≥1.6%). All participants underwent initial low-dose CT followed by repeat screening at 1 year.