American Association for Thoracic Surgery Supports USPSTF Recommendation for Lung Cancer Screening

Close Alignment Between USPSTF and AATS Recommendations

Released: 28-Aug-2013 1:00 PM EDT
Source Newsroom: American Association for Thoracic Surgery (AATS)
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Citations AATS Clinical Recommendations

Newswise — Beverly, MA, August 28, 2013 – The American Association for Thoracic Surgery (AATS), a professional organization of surgeons dedicated to the diagnosis, treatment, and cure of diseases of the chest, strongly supports the United States Preventive Services Task Force (USPSTF) draft recommendation for lung cancer screening of asymptomatic smokers.

The draft recommendation posted by the USPSTF for public comment marks the first time in history in which a specific recommendation for screening for asymptomatic smokers to find lung cancer prior to the development of symptoms has been endorsed using low-dose CT scans for smokers with 30 pack years tobacco exposure and between the ages of 55 and 80.

The AATS strongly agrees with the USPSTF draft recommendation. Specifically, the AATS supports:
1) Performing the screening low dose CT scan test once a year, each year.
2) Continuing the screening up to age 80. The AATS believes future refinement of the screening recommendations can be expected to cover Americans over the age of 80 with preserved health.
3) The need to allow Americans with an abnormal screening scan to be evaluated in a specialized center with particular expertise in lung cancer, especially with state-of-the-art experience in minimally invasive diagnostic and surgical methods to treat early stage lung cancer.
4) The plan to link lung cancer screening with access to smoking cessation programs.

In September 2011 the AATS created a multispecialty Lung Cancer Screening and Surveillance Task Force spearheaded by Michael T. Jaklitsch, MD, Associate Professor, Department of Surgery, Harvard Medical School, and Francine L. Jacobson, MD, MPH, Assistant Professor of Radiology, Harvard Medical School. With input from leaders in Radiology, Pulmonary Medicine, Medical Oncology, Radiation Oncology, Pathology, and Thoracic Surgery, in May 2012 this task force, issued a set of clinical guidelines that strongly recommended lung cancer screening using low-dose CT scans on an annual basis for smokers between the ages of 55 and 79. The close alignment of the USPSTF draft guidelines are based on the best scientific evidence currently available.

“Lung cancer is a common and lethal disease. Nearly a quarter million new lung cancer victims will be identified this year,” explains, Dr. Jaklitsch. “Sadly, only 15% of these victims will be found with early stage disease. Yet lung cancer can be cured up to 88% of the time that early stage disease is found. Screening programs have been successful in reducing cancer deaths related to breast cancer (mammography), colon cancer (colonoscopy) and prostate cancer (PSA and rectal exams). Until now there has been no screening test for lung cancer, even though lung cancer kills more Americans than breast cancer, colon cancer, and prostate cancer combined. This historic recommendation will establish lung cancer screening and dramatically reduce deaths from this devastating disease.”

Symptoms of lung cancer include difficulty breathing, coughing up blood, brain metastases, painful bone metastases, metastases to other organs, profound weight loss, and weakness.

Nearly every American has witnessed the suffering caused by lung cancer. AATS President David J. Sugarbaker, MD, Richard E. Wilson Professor, Department of Surgery, Harvard Medical School, comments, “No one deserves to suffer the effects of an advanced stage of disease if a test is currently available to detect and cure the disease prior to symptoms. The time has finally come to use modern technology to prevent this type of suffering in lung cancer victims. Together we can continue to decrease lung cancer deaths.”

AATS is currently developing its next set of recommendations, including the AATS risk calculator, slated for release in 2014.

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NOTES FOR EDITORS
For more information or to schedule an interview with Michael T. Jaklitsch, MD, or AATS President David J. Sugarbaker, MD, contact Matt Eaton, Director of Administration, AATS, at +1 978-299-4515 or press@aats.org.

USPSTF RECOMMENDATION STATEMENT
www.uspreventiveservicestaskforce.org/draftrec.htm

AATS LUNG CANCER SCREENING GUIDELINES
Jaklitsch MT, Jacobson FL, Austin JHM, Field JK, Jett JR, Keshavjee S, et. al. The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg 2012;144:33-8
http://aats.org/multimedia/files/Guidelines/Lung-Cancer-Screening-Using-low-dose-computed-tomography-scans.pdf

BENEFIT OF EARLY SCREENING – TWO CASES IN POINT
A 69-year old woman had smoked a pack a day since her teenage years when her children asked her to talk to her doctor about screening for lung cancer. Her doctor told her there was no screening test for lung cancer. Two years later, she was admitted to the hospital with shortness of breath and water around one lung. She had an advanced stage of lung cancer. Over the next nine months she suffered from water around the lung requiring surgery to control the water, a painful bone metastasis to a neck bone needing more surgery to replace the bone and provide pain relief for her left hand, profound weight loss, progressive weakness, and airway blockage to one lung with severe shortness of breath. Although chemotherapy slowed the disease, it could not cure it.

A 72-year old man had also smoked a pack a day of cigarettes since his teens when he suffered a painful fall on an icy driveway. A chest x-ray showed no broken ribs, but a shadow on the lung. A chest CT scan suggested a likely early stage lung cancer. The man was successfully treated for his stage Ia lung cancer, and was able to successfully quit smoking. Revitalized, he took up long distance biking and enjoyed a more active lifestyle.

ABOUT THE AMERICAN ASSOCIATION FOR THORACIC SURGERY (AATS)
The American Association for Thoracic Surgery (AATS) is an international organization of over 1,300 of the world’s foremost thoracic and cardiothoracic surgeons, representing 35 countries. AATS encourages and stimulates education and investigation into the areas of intrathoracic physiology, pathology and therapy. Founded in 1917 by a respected group of the last century’s earliest pioneers in the field of thoracic surgery, the AATS’ original mission was to “foster the evolution of an interest in surgery of the Thorax.”

One hundred years later, the AATS continues to be the premiere association among cardiothoracic surgeons. The purpose of the Association is the continual enhancement of the ability of cardiothoracic surgeons to provide the highest level of quality patient care. To this end, the AATS encourages, promotes, and stimulates the scientific investigation and study of cardiothoracic surgery. Visit www.aats.org.


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