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Pack-year rules miss people who get lung cancer without heavy smoking, including East Asian women who never smoked, as Taiwan's TALENT study showed. Eligibility by a validated risk model with a set threshold, plus a never-smoker arm where family history matters, would find more cancers per scan.
PLCOm2012 risk-based selection is more efficient than USPSTF criteria; Taiwan's TALENT study found high detection in never-smoking women with family history. Propose eligibility by a validated risk model with a threshold (e.g. 1.5% six-year risk) plus a never-smoker arm for populations with high never-smoker incidence.
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The document that defines who is offered a scan in the United States, and therefore the document any argument about the screening eligibility gap has to engage with. Eligibility is still defined by pack-years and years since quitting rather than by an individual risk estimate.
Lung screening works when it uses volumetric nodule management, and it works against a no-screening control. The protocol underpins the UK Targeted Lung Health Check programme and European recommendations. Benefit in women remains less precisely estimated.
The clearest published demonstration that a screening eligibility rule can be accurate on average and systematically wrong for a group. It is the empirical core of the argument for replacing pack-year thresholds with individual risk models.
For people with a heavy smoking history, an annual low-dose CT scan is one of the few screening tests proven to reduce cancer deaths. Most abnormal scans are not cancer, so screening must be paired with careful nodule management. It does not apply to never-smokers or light smokers.
Shares Evaluation of USPSTF Lung Cancer Screening Guidelines Among African American Adult Smokers, NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers, Early detection of cancer, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch.
Shares Evaluation of USPSTF Lung Cancer Screening Guidelines Among African American Adult Smokers, Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Trials do not represent the people who get cancer.
Shares NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms, NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, The hardest cancers are found late.
Shares NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms, NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers, CT (computed tomography), Non-small-cell lung cancer.
Shares Early detection of cancer, Trials do not represent the people who get cancer, The hardest cancers are found late.
Shares Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Trials do not represent the people who get cancer, The hardest cancers are found late.
Shares NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms, NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers, CT (computed tomography), The hardest cancers are found late.
Shares Early detection of cancer, CT (computed tomography), The hardest cancers are found late, Non-small-cell lung cancer.