title: Lung cancer screening.
abstract: OBJECTIVE
  Advances in imaging technologies and biomarker research offer hope that the incidence and mortality of lung cancer can be reduced by screening similar to what have been achieved for cancer of the cervix, breast, and colon.
  
  
  RESULTS
  Spiral computed tomography with multitrack scanners and autofluorescence bronchoscopy offer unprecedented sensitivity to detect lung cancer even during the preinvasive stage. The high sensitivity of these tests, however, is associated with a low specificity. Better selection of individuals at highest risk of lung cancer using biomarkers in sputum, blood, or exhaled breath, as well as a better understanding of genetic susceptibility, may improve their positive predictive values, minimize unnecessary downstream investigations or treatment, as well as reduce screening costs.
  
  
  CONCLUSIONS
  Improvement in the performance of sputum, exhaled breath, or blood biomarkers holds promise as the first screening step to identify individuals at highest risk of lung cancer beyond what age and smoking could predict to select those who would obtain the most benefits from spiral computed tomography or autofluorescence bronchoscopy as localization tools.
authors.affiliation: British Columbia Cancer Agency, Vancouver, Canada.
authors.forename: Annette
authors.initials: A
authors.lastname: McWilliams
authors.forename: Stephen
authors.initials: S
authors.lastname: Lam
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001999:Bronchoscopy; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D008403:Mass Screening / Q000379:methods*; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed
chemical_list: D015415:Biomarkers