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Current and former heavy smokers should begin annual lung cancer screening with low-dose computed tomography (CT) at age 50, according to updated recommendations from the U.S. Preventive Services Task Force (USPSTF).

The update lowers the age for the start of screening by 5 years. USPSTF also redefined "heavy smoker" as a 20 pack-year history (one pack of cigarettes daily for 20 years), a reduction of 10 pack-years from the prior recommendation.

The two changes will double the number of people eligible for lung cancer screening, according to a statement from the USPSTF.

"By screening people who are younger and who have smoked fewer cigarettes, we can save more lives and help people remain healthy longer," said Task Force member Michael J. Barry, MD, of Massachusetts General Hospital in Boston.

The expanded eligibility criteria will be especially helpful for Black individuals and women, as both demographic groups tend to smoke fewer cigarettes as compared with white men. Moreover, Black people have an increased risk of developing lung cancer.

The changes are a step in the right direction, said USPSTF member John B. Wong, MD, of Tufts Medical Center, also in Boston.

"However, to save more lives and ensure that everyone who would benefit is screened, it is critical that screening is implemented broadly and equitably," Wong said in the statement.

Published simultaneously on the the and in , the updated recommendations are consistent with a draft published for public comment last summer. Consistent with the 2013 version, USPSTF recommends annual screening of high-risk individuals until age 80, including people who have quit smoking within the past 15 years.

If editorial commentary is an indication, the updated recommendations will get kudos from some healthcare specialists and leave others calling for more. Authors of a editorial applauded the expanded indications for screening, but increasing eligibility without the means to do so "will very likely perpetuate the problem of limited implementation."

Editorialists for also welcomed the changes to increase screening eligibility but noted that the recommendations do not address lung cancer risk factors beyond smoking and the growing percentage of lung cancer patients who have never smoked. The publication also ignores evidence that a substantial proportion of lung cancer diagnoses in ex-smokers occur more than 15 years after cessation.

Authors of a commentary in also welcomed the expanded eligibility criteria while highlighting the need for systematic implementation guidance and adherence to the guidance.