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
cjyang@mgh.harvard.edu

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)