Question of the Week # 270

270 )  A 62 year old man presents with complaints of chronic cough for the past two years. Cough occurs mostly in the morning and is associated with mild sputum production. Lately, he has noticed mild shortness of breath on exertion. He denies any chest pain or weightloss. He has a 50 pack year history of smoking. He has been counselled against smoking several times in the past but he believes it is quite difficult for him to quit smoking. He is concerned about lung cancer and requests if he can placed on an annual screening protocol. A chest x-ray and a CT scan of the chest show changes consistent with chronic obstructive pulmonary disease. There is no evidence of malignancy. Which of the following is the most appropriate screening recommendation for this patient?

A) Sputum Cytology every 6 months

B) Chest X-ray annually

C) No Screening

D) Spiral CT scan annually

E) PET scan annually

14 Responses

  1. C) No Screening

  2. d)

  3. new guidelines is spiral ct

  4. C

  5. No screening.

  6. c

  7. d

  8. C

  9. ACCP does not recommend spiral or helical CT for lung cancer screening.

  10. For the boards it is C but in real lfe now is spiral ct Alan

  11. USPTF says —No screening—-why? cost effective? early diagnosis is better out come and reduce the anxiety?

  12. C) there is no screening for CA lung

  13. According to latest USPSTF – current smokers (or have quit within the last 15 years) aged 55 to 79 years old who have a smoking history of 30 pack-years or greater should get annual spiral CT

  14. The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. 

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