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Invited Commentary
October 28, 2021

Most Survivors of Head and Neck Cancer Should Be Offered Lung Cancer Screening

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Saint Louis University Hospital, St Louis, Missouri
JAMA Otolaryngol Head Neck Surg. Published online October 28, 2021. doi:10.1001/jamaoto.2021.2813

In 2011, the National Lung Screening Trial (NLST) demonstrated a survival benefit from screening individuals at high risk for lung cancer using low-dose computed tomography.1 Since then, these results have been further developed in other studies, incorporated into preventive care guidelines, and gradually expanded. This success should translate into a substantial survival benefit at a population level; unfortunately, implementation of this effective tool remains low at 14%.2 Survivors of head and neck cancer (HNC) represent a unique group that may benefit even more from screening. With improving HNC survival, it is imperative for clinicians and researchers to consider the survivorship needs of these patients, including providing effective health maintenance interventions, such as lung cancer screening. In this study by Cramer et al,3 an unplanned secondary analysis of the NLST data demonstrates that patients with a history of HNC have substantially higher rates of lung cancer detection with screening, even after controlling for smoking history. Efforts to clarify and expand the screening eligibility criteria are welcome. However, with up to 94% of patients with HNC having a smoking history,4 the vast majority of this population already qualifies for screening.

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