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NLM Director’s Comments Transcript
CT Scans Recommended for Heavy Smokers: 02/18/2014

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Greetings from the National Library of Medicine and

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

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New recommendations from an influential medical panel, recently published in the Annals of Internal Medicine, suggest low dose, annual CT scans should be provided to many current and former heavy smokers to prevent deaths from lung cancer.  

The U.S. Preventive Services Task Force recommends annual computer tomography (or CT) screening for smokers between age 55-80, who currently smoke or have smoked an average of a pack of cigarettes a day for 30 years. Low dose CT scans also are recommended for adults between age 55-80, who smoked an average of a pack of cigarettes a day for 30 years — and quit within the past 15 years.

Michael LeFevre M.D., the Task Force’s co-vice chair, told the Wall Street Journal (after the recommendations’ release) the recommended screening could prevent as many as 20,000 lung cancer deaths annually. Dr. LeFevre told Health Day (and we quote): ‘That’s a lot of people, and we feel it’s worth it, but there still will be a lot more people dying from lung cancer. That’s why the most important way to prevent lung cancer will continue to be to convince smokers to quit’ (end of quote).

The Task Force’s report notes about 160,000 Americans die from lung cancer annually and about 230,000 new cases are diagnosed each year. Lung cancer is the third most common and deadliest of all cancers and impacts both men and women. The Task Force’s report explains about 37 percent of adults are current or former smokers.

The Task Force’s recommendations are based on an eight year study of 53,000 current and former heavy smokers that found 20 percent fewer deaths occurred within a group who received low dose CT scans compared to participants who were screened by standard x-rays. The study was sponsored by the National Cancer Institute and accompanied the Task Force’s report.

The U.S. Preventive Services Task Force is appointed by the Agency for Healthcare Research and Quality and provides invited, independent, evidence-based, clinical guidelines on a variety of disease prevention and other topics. Interestingly, the Task Force’s recommendations are more than a suggestion. If the Task Force suggests tests and therapies (such as the CT scans recommended here), they are required to be adopted by health insurers under the U.S. Affordable Care Act. Hence, the new guidelines could mean about 10 million older adult, heavy smokers in the U.S. will receive health insurance coverage for annual, low dose CT scans. 

While one of two editorials that accompanied the study acknowledged the value of the Task Force’s recommendations, the authors noted its implementation requires more than performing and evaluating a CT scan. The editorial’s authors write there are added costs and burdens to (and we quote): ‘make the process of patient selection and counseling achievable and to make contribution to a registry and tracking of quality metrics actually happen’ (end of quote).

Full disclosure: I occasionally participate in programs to educate health care providers and journalists about medical research and clinical guidelines with Dr. LeFevre, the Task Force’s co-vice chair.

You can find helpful information about CT scans and x-rays for lung cancer (from the National Heart, Lung, and Blood Institute) in the ‘diagnosis/symptoms’ section of’s lung cancer health topic page. An overview of diverse lung cancer treatments (from the American Lung Association) is found in the ‘treatments’ section of’s lung cancer health topic page.’s lung cancer health topic page also provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about lung cancer as they become available on

To find’s lung cancer health topic page type ‘lung cancer’ in the search box on’s home page. Then, click on ‘lung cancer (National Library of Medicine).’ also contains health topic pages on smoking and lung diseases.

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Page last updated on 12 November 2013