Lung Cancer

Summary of recommendations for clinicians and policy-makers

The CTFPHC will continue to carefully monitor the scientific developments in screening for lung cancer and will report back to Canadians within 5 years with an update of the 2016 guidelines.

These recommendations apply to adults aged 18 years and older who are not suspected of having lung cancer. These recommendations do not apply to individuals who have a history of lung cancer, or suspected lung cancer.

The CTFPHC based the recommendations on the overall balance between the possible benefits and harms of screening for lung cancer, weighing the potential benefits of early disease detection against the harms of overdiagnosis and invasive follow up testing.

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Recommendations

• Low dose computed tomography (LDCT)
  • For adults aged 55-74 years with at least a 30 pack-year* smoking history who currently smoke or quit less than 15 years ago, we recommend annual screening with LDCT up to three consecutive times. Screening should ONLY be carried out in health care settings with expertise in early diagnosis and treatment of lung cancer.
    Weak recommendation; low quality evidence.*pack-year defined as the (average number of cigarette packs smoked daily) x (number of years smoking)
  • For all other adults, regardless of age, smoking history or other risk factors, we recommend not screening for lung cancer with LDCT.
    Strong recommendation; very low quality evidence.
• Chest x-ray (CXR)
  • We recommend that chest x-ray not be used to screen for lung cancer, with or without sputum cytology.
    Strong recommendation; low quality evidence.

Additional Documents

• Clinician Summary
• Protocol (pdf)
• Systematic Review (pdf)
• Excluded Studies (pdf)
• Evaluating the Cancer Risk Management Model (pdf)
• Patient Preferences Report (pdf)
• CMAJ Author Podcast
• Webinar Presentation