Practice Guidelines

Cancer Screening: ACS Releases Annual Summary of Recommendations

Am Fam Physician. 2019;99(11):719-722. 

In This Article

Lung Cancer

In its 2013 guidance, the ACS recommended that physicians discuss current smoking, as well as smoking history, with persons 55 to 74 years of age. Subsequently, physicians who have contacts with high-quality treatment facilities also should discuss screening methods and their associated benefits and harms with those patients in good health who have at least a 30-pack-year history of smoking, who smoke currently, or who only quit smoking in the past 15 years. This recommendation, however, has been misconstrued by some physicians to mean that decisions to screen should involve shared decision-making, instead of a firm recommendation to screen combined with appropriate discussions with the patient.

To clarify this recommendation and appropriately place the emphasis, as ACS intended, on a firm recommendation for screening, in 2017, the ACS modified the wording to say that yearly screening should be performed with low-dose computed tomography in this patient population, combined with counseling on smoking cessation in current smokers and provision of information about benefits and harms of such screening. In addition, smoking cessation counseling was emphasized as an important component of identifying adults who should receive screening, which is not a replacement for smoking cessation.