A new analysis is calling for major changes to how the United States screens for lung cancer. Current rules, the study argues, leave out most people who eventually develop the disease. Researchers behind the study say the system used today is far too narrow and fails to capture the full range of Americans who end up at risk.
The work, published in JAMA Network Open, examined nearly one thousand lung cancer cases treated at Northwestern Medicine over a five year span. Researchers set out to determine how many of those patients would have qualified for routine CT scans under the recommendations created by the U.S. Preventive Services Task Force (USPSTF). Those criteria focus on adults between fifty and eighty who have a long history of smoking or who quit within the past decade and a half.
Results showed that only a minority of the patients would have met the current requirements for screening. That shortfall means most people in the study reached treatment only after their cancer was already established, making early detection far less likely. Dr. Luis Herrera of Orlando Health, who reviewed the findings, said many missed cases involved former smokers who quit long ago or individuals who never smoked, which means current screening guidelines do not adequately capture risk across the wider population.
The analysis found that people overlooked by the rules were often diagnosed with adenocarcinoma, a type of cancer frequently seen in those with little or no smoking history. Many were women or patients of Asian descent, highlighting how a screening model built almost entirely around smoking exposure can overlook groups with different risk patterns.
When researchers compared outcomes, they saw that patients outside the screening criteria often survived longer, partly because their tumors behave differently and are sometimes discovered earlier through unrelated imaging.
Participation among people who already qualify for screening remains low as well. Herrera noted that many patients do not pursue testing because the rules are complicated, the stigma tied to smoking persists, and some health providers do not consistently raise the topic. While insurance typically covers the cost of annual scans and many hospitals offer discounted options, awareness remains limited.
Researchers tested a broader approach by modeling universal screening for adults between forty and eighty five, regardless of smoking history. Their projections indicated that this age based model would have detected most cancers in the study group and could prevent tens of thousands of deaths across the country. The estimated cost per life saved would also fall below that of several long standing screening programs for other major cancers.
Study authors acknowledged the limits of reviewing data from a single academic center and noted that real world results could shift once applied nationwide. They also recognized that wider screening could lead to more false positives and additional follow up scans.
Even so, the researchers argue that expanding eligibility would close major gaps in cancer detection, especially for people who never qualify under current rules yet still face the nation’s deadliest cancer.
Improvements in screening and catching the cancer earlier could deliver maximum therapeutic value from the treatments that companies like Calidi Biotherapeutics Inc. (NYSE American: CLDI) are working to commercialize since early treatment increases the odds of successful outcomes.
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