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A new study from Northwestern Medicine suggests that current lung cancer screening guidelines may be missing most Americans who develop the disease — and researchers say it’s time for a major change.

Published in JAMA Network Open, the study analyzed nearly 1,000 lung cancer patients who were treated at Northwestern Medicine between 2018 and 2023. 

The goal was to see how many of those patients would have qualified for screening under existing guidance from the U.S. Preventive Services Task Force (USPSTF).

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USPSTF currently recommends annual CT scans for adults ages 50 to 80 who have a 20 pack-year smoking history (the equivalent of one pack of cigarettes per day for 20 years) and either still smoke or quit within the last 15 years.

Only about 35% of those diagnosed with lung cancer met the current criteria to undergo screenings.

That means roughly two-thirds of patients would not have been flagged for testing before their diagnosis.

“Not only does that approach miss many patients who had quit smoking in the past or did not quite meet the high-risk criteria, it also misses other patients at risk of lung cancer, such as non-smokers,” Luis Herrera, M.D., a thoracic surgeon at Orlando Health, told Fox News Digital.

The study noted that these patients tended to have adenocarcinoma, the most common type of lung cancer among never-smokers.

Those missed by the guidelines were more often women, people of Asian descent and individuals who had never smoked, the study found.

The research team also compared survival outcomes. Patients who didn’t meet the screening criteria had better survival, living a median of 9.5 years compared with 4.4 years for those who did qualify. 

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While this difference partly reflects tumor biology and earlier detection, it also highlights how current screening rules fail to catch a broad range of cases that could be treated sooner, according to researchers.

“The current participation in lung cancer screening for patients who do qualify based on smoking history is quite low,” said Herrera, who was not involved in the study. This is likely due to the complexity of the risk-based criteria and stigma associated with smoking and lung cancer, he added.

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To test an alternative, the researchers modeled a different approach: screening everyone between the ages of 40 and 85, regardless of smoking history. 

Under that universal, age-based model, about 94% of the cancers in their cohort would have been detected.

Such a change could prevent roughly 26,000 U.S. deaths each year, at a cost of about $101,000 per life saved, according to their estimates. 

The study emphasized that this would be far more cost-effective than current screening programs for breast or colorectal cancer, which cost between $890,000 and $920,000 per life saved.

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Herrera noted the many challenges in the adoption of lung cancer screening, from lack of awareness to some providers not recommending the screening test.

However, he added, “The cost of screening is covered by most health insurance plans and many institutions also offer discounts for patients who don’t have insurance.”

“The current participation in lung cancer screening for patients who do qualify based on smoking history is quite low.”

Lung cancer remains the deadliest cancer in the country, killing more people each year than colon, prostate and breast cancer combined. But because of the narrow eligibility criteria based on smoking history, millions at risk never get screened.

Northwestern Medicine researchers argue that expanding screening to include all adults within an age range could help close those gaps, especially for groups often underdiagnosed.

The study was conducted at a single academic center, which means the patient population may not represent the wider U.S. population. It also looked back at existing data, so it can’t prove how the new model would perform in real-world screening programs, the researchers acknowledged.

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The cost and mortality projections rely on assumptions that could shift depending on how screening is implemented. 

The researchers also didn’t fully account for the potential downsides of broader screening, such as false positives or unnecessary follow-ups, they noted.

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For patients who don’t qualify for lung cancer screening, there are other opportunities for lung evaluations, including “heart calcium scores, CT scans and other imaging modalities that can at least evaluate the lungs for any suspicious nodules,” Herrera added.

Days after Tatiana Schlossberg announced that she has terminal cancer, the spotlight is on the warning signs of acute myeloid leukemia (AML).

John F. Kennedy’s granddaughter, 35, shared the details of her diagnosis in an essay published in The New Yorker on Nov. 22.

Schlossberg, who is the daughter of Kennedy’s daughter, Caroline Kennedy, and Edwin Schlossberg, learned of her disease in May 2024. 

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She wrote that one doctor predicted she would live for about a year.

The first indicator of Schlossberg’s disease was an abnormally high white blood cell count, which doctors detected just hours after she gave birth to her second child.

What is acute myeloid leukemia?

AML is a type of leukemia that begins in the bone marrow, the soft, inner tissue of certain bones where new blood cells are produced, according to the American Cancer Society.

This type of cancer typically spreads rapidly from the bone marrow into the bloodstream and can also reach other parts of the body, such as the lymph nodes, liver, spleen, brain and spinal cord, and testicles, per ACS.

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In some cases, clusters of leukemia cells may form a solid mass known as a myeloid sarcoma.

Schlossberg’s AML stems from a rare gene mutation known as inversion 3, which is an abnormality of chromosome 3 in the leukemia cells.

“Inversion 3 correlates with a very high rate of resistance to standard chemotherapy treatments and, therefore, very poor clinical outcomes,” Dr. Stephen Chung, a leukemia expert and oncologist at UT Southwestern Medical Center in Dallas, Texas, told Fox News Digital. (Chung was not involved in Schlossberg’s care.)

Red flags and risk factors

The most common symptoms of Schlossberg’s type of cancer include sudden onset of severe fatigue, shortness of breath with exertion, unusual bleeding or bruising, fever and infections, according to Dr. Pamela Becker, professor in the Division of Leukemia at City of Hope, a U.S. cancer research and treatment organization in California, who also did not treat Schlossberg.

AML can sometimes resemble a severe flu with a generally unwell feeling. 

Chung noted that AML usually causes abnormally low blood cell counts, or in some cases an abnormally high white blood cell count.

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“This may be picked up in routine testing for other purposes, or because the patient develops symptoms from these low blood counts,” he said. 

AML can sometimes resemble a severe flu with a generally unwell feeling, noted Robert Sikorski, M.D., Ph.D., a hematology/oncology expert and chief medical officer of Cero Therapeutics in California. 

“Some patients also experience bone pain or night sweats,” he told Fox News Digital.

Known risk factors for AML include prior chemotherapy or radiation, smoking, long-term benzene exposure and certain inherited syndromes, although most cases occur without any identifiable cause, according to Sikorski, who has not treated Schlossberg.

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In some rare cases, people can inherit mutations that cause AML to run in families, with recent research suggesting that these cases may be more common than previously thought, Chung noted.

“We used to only check for this in younger AML patients, but we now believe all patients should be screened for these mutations,” he said.

Treatment for AML

The standard treatment for AML is intensive chemotherapy with a combination of two drugs, with additional agents added based on each patient’s specific characteristics, according to Becker.

“We now believe all patients should be screened for these mutations.”

For patients with higher-risk types of AML, the chemotherapy is usually followed by a stem cell (bone marrow) transplant to prevent relapse. The transplants come from matched donors, often family members.

“This is a much more involved process that usually involves another month in the hospital, followed by close follow-up for many months, as well as a much higher risk for treatment-related side effects,” Chung said.

There is not a specific treatment that is effective for Schlossberg’s specific chromosome abnormality, the doctors noted, although some new cellular therapies and immunotherapies are being investigated.

For older patients who are not strong enough to receive intensive chemotherapy, the standard treatment is venetoclax/azacytidine (a combination therapy used to treat certain types of AML), Chung said.

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“This can often be given mostly outside the hospital on a monthly basis,” he said. “While it technically is not considered to be curative, it can work very well — in some cases, patients remain in remission for many months, if not years.”

Hope ahead

There is hope on the horizon, as AML treatment has advanced more in the past decade than in the previous 30 years, according to Sikorski.

“New targeted drugs have been approved in several AML subtypes, and early work in immune-based therapies, including CAR-T and other engineered cell therapies, is beginning to reach clinical trials for AML,” Sikorski, told Fox News Digital.

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“Supportive care has also improved significantly, which helps patients tolerate treatment more effectively.” 

While there is not yet a drug tailored specifically to inversion 3, he reiterated, “many studies focused on high-risk AML are actively enrolling these patients, and the overall treatment landscape continues to expand.”