Observational studyThe Lancet. Oncology2019
5-year overall survival in patients with lung cancer eligible or ineligible for screening according to US Preventive Services Task Force criteria: a prospective, observational cohort study.
Observational study in The Lancet. Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
60 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Plasma Proteome Profiling Identifies Biomarkers and Potential Drug Targets for Non-Small Cell Lung Cancer.International journal of medical sciences · 2025Pooled it
- The Epidemiology of Ground Glass Opacity Lung Adenocarcinoma: A Network-Based Cumulative Meta-Analysis.Frontiers in oncology · 2020Pooled it
- Immune killer cells treatment for previously treated stage IV NSCLC patients.Scientific reports · 2024Trial
- Screening Eligibility and Survival Among Patients With Lung Cancer in Korea.JAMA network open · 2026Article
- Article
- Changes in Depressive Patterns Before and After Lung Cancer Diagnosis: A Nationwide Population-Based Study.Psycho-oncology · 2025Article
- Article
- Thromboinflammatory Biomarkers Are Early Predictors of Disease Progression in Non-Small Cell Lung Cancer Patients.Cancers · 2025Article
- Development of indole hybrids for potential lung cancer treatment-part I: nitrogen-containing six-membered aromatic heterocycles.Future medicinal chemistry · 2025Review
- Treatment of lung diseasesMaterials today. Bio · 2025Review
- Prospective validation study: a non-invasive circulating tumor DNA-based assay for simultaneous early detection of multiple cancers in asymptomatic adults.BMC medicine · 2025Observational
- Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities.Oncology reports · 2025Article
- Serum exosomal small nucleolar RNA (snoRNA) signatures as a predictive biomarker for benign and malignant pulmonary nodules.Cancer cell international · 2024Article
- Survival of lung cancer patients according to screening eligibility using Korean Lung Cancer Registry 2014-2016.Scientific reports · 2024Article
- Study on psychological resilience and associated influencing factors in lung cancer patients with bone metastases.World journal of psychiatry · 2024Article
- Type I interferon signaling pathway enhances immune-checkpoint inhibition in KRAS mutant lung tumors.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Personalizing Therapy Outcomes through Mitogen-Activated Protein Kinase Pathway Inhibition in Non-Small Cell Lung Cancer.Biomedicines · 2024Review
- Efficacy of Sorafenib-Based Therapies for Non-Small Cell Lung Cancer.Medical sciences (Basel, Switzerland) · 2024Review
- Article
- The Smokers Health Multiple ACtions (SMAC-1) Trial: Study Design and Results of the Baseline Round.Cancers · 2024Article
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Abstract
backgroundThe US Preventive Services Task Force (USPSTF) recommends lung cancer screening among individuals aged 55-80 years with a 30 pack-year cigarette smoking history and, if they are former smokers, those who quit within the past 15 years. Our previous report found that two-thirds of newly diagnosed patients with lung cancer do not meet these criteria; they are reported to be either long-term quitters (≥15 years since quitting) or from a younger age group (age 50-54 years). We aimed to assess survival outcomes in these two subgroups.
methodsFor this prospective, observational cohort study we identified and followed up patients aged 50-80 years with lung cancer, with a smoking history of 30 pack-years or more, and included both current smokers and former smokers who quit within the past 30 years. We identified patients from two cohorts in the USA: a hospital cohort (Mayo Clinic, Rochester, MN) and a community cohort (Olmsted County, MN). Patients were divided into those meeting USPSTF criteria (USPSTF group) versus those not meeting USPSTF criteria (long-term quitters or the younger age group). The main outcome was overall survival at 5 years after diagnosis. 5-year overall survival was analysed with and without matching age and pack-years smoked for long-term quitters. The USPSTF group was subdivided into two age subgroups (55-69 years and 70-80 years) for multivariable regression analysis.
findingsBetween Jan 1, 1997, and Dec 31, 2017, 8739 patients with lung cancer were identified and followed up. Median follow-up was 6·5 (IQR 3·8-10·0) years, and median overall survival was 16·9 months (95% CI 16·2-17·5). 5-year overall survival was 27% (95% CI 25-30) in long-term quitters, 22% (19-25) in the younger age group, and 23% (22-24) in the USPSTF group. In both cohorts, 5-year overall survival did not differ significantly between long-term quitters and the USPSTF group (hospital cohort: hazard ratio [HR] 1·02 [95% CI 0·94-1·10]; p=0·72; community cohort: 0·97 [0·75-1·26]; p=0·82); matched analysis showed similar results in both cohorts. 5-year overall survival also did not differ significantly between the younger age group and the USPSTF group in both cohorts (hospital cohort: HR 1·16 [95% CI 0·98-1·38], p=0·08; community cohort: 1·16 [0·74-1·82]; p=0·52); multivariable regression analyses stratified by age group yielded similar findings.
interpretationPatients with lung cancer who quit 15 or more years before diagnosis and those who are up to 5 years younger than the age cutoff recommended for screening, but otherwise meet USPSTF criteria, have a similar risk of death to those individuals who meet all USPSTF criteria. Individuals in both subgroups could benefit from screening, as expansion of USPSTF screening criteria to include these subgroups could enable earlier detection of lung cancer and improved survival outcomes.
fundingNational Institutes of Health and the Mayo Clinic Foundation.
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