In a departure from their previous guidelines, the American Cancer Society (ACS) now recommends that individuals with a history of heavy cigarette smoking undergo regular lung cancer screening, even if they have quit smoking many years ago. The guidance, released in CA: A Cancer Journal for Clinicians on November 1st, aims to address the increasing risk of lung cancer among the elderly.

Dr. William Dahut, the chief scientific officer for the ACS, explained that the risk of developing lung cancer is greatest in individuals in their 60s and beyond, a time when they may have stopped regular screening. There is concern that people developed a false sense of security, which likely contributed to the "abysmally low" rates of screening, according to Dahut in an interview with NBC.

Currently, only about 10% of eligible individuals in the United States undergo annual lung cancer screening, with rates varying among states, according to Robert Smith, senior vice president for early cancer detection science at the ACS. To address this issue, the ACS is broadening its guidelines in several key ways.

Formerly, the ACS recommended annual screening for individuals between the ages of 55 and 74 who had at least a 30 "pack-year" smoking history and had quit less than 15 years ago. These guidelines have now been expanded to include current and former smokers aged 50 to 80 with a 20 pack-year smoking history, regardless of when they quit smoking. These changes mean that approximately 19.3 million people in the U.S. are now eligible for screening, compared to the previous estimate of 14.3 million, as reported by NBC.

Lung cancer screening primarily involves low-dose computed tomography (low-dose CT), a scan that provides a detailed image of the inside of the body by combining a series of X-rays. Although a small percentage of people do undergo screening, many fail to get their subsequent scan the following year, indicating a lack of awareness that lung cancer screening is a continuous process.

The new ACS guidelines align closely with recommendations from the U.S. Preventive Services Task Force (USPSTF), another panel of experts in primary care and prevention. The USPSTF also suggests annual screening for adults aged 50 to 80 with a 20 pack-year smoking history, although they still maintain that individuals can discontinue screenings if it has been more than 15 years since they quit smoking.

Dr. Matthew Triplette, a pulmonologist and cancer prevention researcher at the Fred Hutchinson Cancer Center in Seattle, who was not involved in either set of guidelines, commented that the ACS' recommendations reflect newer modelling evidence. This evidence suggests that the risk of lung cancer continues to rise with age, even for individuals who have quit smoking for 15 or more years.

The ACS hopes that by expanding the guidelines and emphasizing the importance of regular lung cancer screening, more individuals at risk can be diagnosed early, increasing the chances of successful treatment and potentially saving lives.