This is the current release of the guideline.

This guideline updates a previous version: Bach PB, Niewoehner DE, Black WC, American College of Chest Physicians. Screening for lung cancer: the guidelines. Chest 2003 Jan;123(1 Suppl):83S-8S.

Definitions for the strength of evidence and recommendation grades (1A-2C) follow the recommendations.

1. We do not recommend that low-dose helical CT be used to screen for lung cancer except in the context of a well-designed clinical trial. Grade of recommendation, 2C
2. We recommend against the use of serial chest radiographs to screen for the presence of lung cancer. Grade of recommendations, 1A
3. We recommend against the use of single or serial sputum cytologic evaluation to screen for the presence of lung cancer. Grade of recommendation, 1A

Definitions:

Quality of Evidence Scale

High - Randomized controlled trials (RCTs) without important limitations or overwhelming evidence from observational studies*

Moderate - RCTs with important limitations (inconsistent results, methodologic flaws, indirect, or imprecise) or exceptionally strong evidence from observational studies*

Low or very low - Observational studies or case series

*Although the determination of magnitude of the effect based on observational studies is often a matter of judgment, the guideline developers offer the following suggested rule to assist this decision: a large effect would be a relative risk > 2 (risk ratio < 0.5) [which would justify moving from weak to moderate], and a very large effect is a relative risk > 5 (risk ratio < 0.2) [which would justify moving from weak to strong]. There is some theoretical justification in the statistical literature for these thresholds (the magnitude of effect that is unlikely or very unlikely to be due to residual confounding after adjusted analysis). However, once the decision is made, authors should be explicit in justifying their decisions.

Grade of Recommendations Scale

Relationship of Strength of the Supporting Evidence to the Balance of Benefits to Risks and Burdens

None provided

The type of supporting evidence is identified and graded for each recommendation (see "Major Recommendations").

Not applicable: The guideline was not adapted from another source.

2003 Jan (revised 2007 Sep)

American College of Chest Physicians - Medical Specialty Society

American College of Chest Physicians

American College of Chest Physicians (ACCP) Expert Panel on Lung Cancer Guidelines

Primary Authors: Peter B. Bach, MD, FCCP; Gerard A. Silvestri, MD, FCCP; Morgan Hanger, BA; James R. Jett, MD, FCCP

American Association for Bronchology - Disease Specific Society
American Association for Thoracic Surgery - Medical Specialty Society
American College of Surgeons - Medical Specialty Society
American Society for Therapeutic Radiology and Oncology
Asian Pacific Society of Respirology - Disease Specific Society
Oncology Nursing Society - Professional Association
Society of Thoracic Surgeons - Medical Specialty Society
World Association of Bronchology - Disease Specific Society

This is the current release of the guideline.

This guideline updates a previous version: Bach PB, Niewoehner DE, Black WC, American College of Chest Physicians. Screening for lung cancer: the guidelines. Chest 2003 Jan;123(1 Suppl):83S-8S.

This NGC summary was completed by ECRI on June 30, 2003. The information was verified by the guideline developer on July 25, 2003. This NGC summary was updated by ECRI Institute on November 7, 2007. The updated information was verified by the guideline developer on December 21, 2007.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.