A Proposal to Expand Lung Cancer Screening

The U.S. Preventive Services Task Force (USPSTF) on July 7 released a draft of new recommendations for routine lung cancer screening. USPSTF recommendations determine what preventive services must be covered by health insurers at no cost to patients. Decisions on lung cancer screening—which is done via low-dose CT scan—are based on age and smoking history. The new draft guidelines lower the age at which people with sufficient smoking history should start lung cancer screening from age 55 to 50. They also lower the threshold for determining who is at elevated risk due to smoking. Currently, people are recommended to get screened if they have smoked within the past 15 years and have a 30 pack-year smoking history, defined as smoking a number of cigarettes equivalent to smoking a pack a day for 30 years. The draft guidelines say that people should get screening if they have smoked within the past 15 years and have a 20 pack-year smoking history. “Some really good news from the changes to this recommendation is that it will mean more people are eligible for screening, including notably more African Americans and women,” John Wong, a physician at Tufts Medical Center in Boston and task force member, told STAT. African Americans appear to be at greater risk of lung cancer than white Americans at lower levels of daily smoking, the guidelines note. The draft guidance is currently available for public comment.

Catch-Up HPV Vaccines at Older Ages?

The American Cancer Society (ACS) on July 8 released recommendations on when people should get vaccinated for the human papillomavirus (HPV). The HPV vaccine can reduce risk of infection with types of the virus that cause cervical, head and neck, vulvar, vaginal, penile and anal cancer. The new ACS recommendations are adapted from 2019 recommendations put out by the Advisory Committee on Immunization Practices (ACIP), a Centers for Disease Control and Prevention committee that helps determine which vaccines health insurance must cover at no cost to patients. ACIP recommends that children routinely begin their HPV vaccine series at age 11 or 12, although the vaccines can be given as early as age 9. ACS recommends that health care providers start offering the vaccine at age 9 or 10. Both groups agree that if people miss getting vaccinated as children, they should catch up on vaccinations through age 26, although ACS notes that people age 22 and up should be told the vaccination is less effective at reducing cancer risk at older ages. However, while the ACIP recommendations urge shared decision-making between doctors and patients on whether to get vaccinated for those ages 27 to 45, the ACS does not endorse this conversation, citing low effectiveness of the vaccine and low potential for preventing cancer in this group. The ACS also notes that there is a shortage globally of HPV vaccines.

At-Home Treatment for Myelodysplastic Syndromes

The Food and Drug Administration (FDA) on July 7 approved Inqovi, which is a pill that combines a previously approved drug, decitabine, with cedazuridine, for patients with myelodysplastic syndromes, which are a form of blood cancer. Decitabine modifies the epigenetics of cells, meaning it alters chemical marks on genetic material, while cedazuridine prevents the breakdown of decitabine. Richard Pazdur, director of the FDA’s Oncology Center of Excellence, noted in a press release​ that oral drugs like the new combination pill can reduce the need for cancer patients to visit health care facilities and risk exposure to the coronavirus. “At this critical time, we continue to focus on providing options to patients with cancer, including regimens that can be taken at home,” he said.​​ ​​​

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