Older individuals up to the age of 80 who are eligible for lung surgery may achieve a survival benefit from lung cancer screening comparable to that for younger patients, according to the results of a multicenter cohort study from the United Kingdom presented at the International Association for the Study of Lung Cancer (IASLC) 2025 World Conference on Lung Cancer (WCLC; Abstract PL03.19). The findings support a push to extend the upper limit of lung cancer screening recommendations across national programs to include individuals aged 75 to 80, in line with the U.S. Preventive Services Task Force’s recommendations.
“Our findings suggest that extending lung cancer screening up to age 80 could be valuable for older adults who are fit for surgery,” stated presenting author Patrick Goodley, PhD, Honorary Senior Research Fellow, Division of Immunology, Manchester University NHS Foundation Trust, United Kingdom. “Screening selection incorporating surgical fitness, rather than age alone, may allow us to deliver curative treatment to more people with lung cancer.”
Background and Study Methods
The UK Lung Cancer Screening Program, and other national programs, currently recommend screening individuals for lung cancer up to age 74. This is in contrast with the guidelines from the U.S. Preventive Services Task Force, which recommend screening individuals up to age 80. However, about half of lung cancers are diagnosed in individuals 75 years or older.
The researchers conducted a multicenter cohort study in the UK to inform the optimal upper age limit for lung cancer screening. The Yorkshire Lung Screening Trial (YLST) and North & East Manchester Lung Health Check (NEM-LHC) were initiated in 2019 to include individuals with a smoking history. The researchers collated treatment and survival information for patients diagnosed with invasive lung cancers confirmed on screening from these two programs and analyzed them by age groupings of 55 to 74 vs 75 to 80.
Key Study Findings
A total of 574 lung cancers were diagnosed in this patient population, with 190 (33%) among the older age group. A total of 87% of older patients (aged 75–80) were treated with curative intent, but surgical resection rates were lower for these patients compared with the younger age group (42% vs 58%; P < .001).
At 4 years from diagnosis, all-cause mortality rates were 44% in the older age group vs 34% in the younger age group (hazard ratio [HR] = 1.54; 95% confidence interval [CI] = 1.12–2.10; P < .001). Overall survival was higher in the younger age group vs the older patients for those with screen-detected lung cancer (P = .0071). Among patients treated with surgery, no survival difference was observed between the two age groups, at 16% for those aged 75 to 80 vs 18% for those aged 55 to 74 (HR = 1.00; 95% CI = 0.47–2.11; P = 1).
Disclosure: For full disclosures of the study authors, visit abstractsonline.com.
