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Performance of the 20-year Duration Guideline Compared to the Breast and Colorectal Cancer Screening Guidelines

Principal Investigator
Name
Chi-Fu Jeffrey Yang
Degrees
M.D.
Institution
Massachusetts General Hospital
Position Title
Thoracic Surgeon at Massachusetts General Hospital
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
PLCO-1963
Initial CDAS Request Approval
Jul 28, 2025
Title
Performance of the 20-year Duration Guideline Compared to the Breast and Colorectal Cancer Screening Guidelines
Summary
Lung cancer screening is currently restricted to individuals 50-80 who have smoked over 20 pack-years, and are currently smoking or have quit within the last 15 years. There is a growing body of literature that suggests these guidelines are inequitable. As a result, revisions to the guideline are necessary to ensure health equity without a loss of screening efficiency. In this project, we will evaluate the performance of the 2021 USPSTF lung cancer screening guideline compared to a proposed 20-year duration guideline. In addition, the number needed to screen (NNS) of the 20-year duration guideline to detect one lung cancer will be compared to the NNS of the current USPSTF breast and colorectal cancer screening guidelines.
Aims

- To evaluate the performance (sensitivity, specificity, and number needed to screen) of a newly proposed 20-year duration guideline—which replaces the 20-pack-year cutoff in the 2021 USPSTF lung cancer screening guideline with a 20-year smoking duration cutoff—and compare it to that of the 2021 USPSTF lung cancer screening guideline. A subgroup analysis by race for all performance metrics will also be calculated.
- To compare the number needed to screen (NNS), or the number of individuals who need to undergo cancer screening for one cancer case to be detected, of a new proposed 20-year duration guideline to that of the USPSTF breast and colorectal cancer screening guidelines.

Collaborators

Alexandra Potter (Massachusetts General Hospital)
Quiana Guo (Massachusetts General Hospital)