Older individuals between the ages of 75 and 80 who are eligible for lung surgery may achieve survival outcomes comparable to younger patients following lung cancer screening, according to research presented today at the International Association for the Study of Lung Cancer (IASLC) 2025 World Conference on Lung Cancer (WCLC).
Despite half of lung cancers being diagnosed in people aged 75 or older, randomized evidence on screening outcomes in this age group is limited. Most national lung cancer screening programs, including the UK's, stop at age 74. The U.S. Preventive Services Task Force recommends screening up to age 80, although little was known about how much benefit is achieved by extending the upper age limit to 80. This study compared outcomes between patients aged 55–74 and those aged 75–80 diagnosed with screen-detected lung cancer in two UK targeted lung cancer screening programs.
The Yorkshire Lung Screening Trial (YLST) and the North & East Manchester Lung Health Check (NEM-LHC) program systematically invited people with a history of smoking beginning in 2019. Researchers analyzed clinical data from 574 invasive lung cancer cases, of which 190 (33%) were in the 75–80 age group. Stage distribution was similar between age groups.
Curative-intent treatment rates were high overall (87%), but surgical resection rates were lower in the older group (42% vs. 58%, p<0.001). All-cause mortality was higher among those aged 75–80 (HR 1.54, 95% CI 1.12–2.10), with mortality at four years being 44% versus 34%. However, in patients treated with surgery, survival rates were comparable between age groups (16% vs. 18% mortality at four years; HR 1.00).
Our findings suggest that extending lung cancer screening up to age 80 could be valuable for older adults who are fit for surgery. Screening selection incorporating surgical fitness, rather than age alone, may allow us to deliver curative treatment to more people with lung cancer."
Patrick Goodley, Manchester University NHS Foundation Trust, United Kingdom
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