Screening for lung cancer: are we there yet?
OBJECTIVE
In lung cancer screening with low-dose spiral computed tomography (LDCT), the proportion of stage I disease is 50-85%, and the survival rate for resected stage I disease can exceed 90%, but proof of real benefit in terms of lung cancer mortality reduction must come from the several randomized trials underway in Europe and in the USA. Our purpose is to update the readers on recent progress in medical knowledge in this field.


RESULTS
Relevant novelties regarding technical and collateral aspects of lung cancer screening have been made available, covering the performance of detection systems and nodule evaluation protocols, means to increase cost-effectiveness, insight into the biology of lung cancer, promotion of minimally invasive and lung-sparing surgical options, effects of screening on smoking habits and early follow-up findings in one randomized trial of LDCT vs. clinical review.


CONCLUSIONS
Early follow-up data suggest that the effect of screening with LDCT on mortality might be smaller than expected, but definitive follow-up data are still awaited from all ongoing randomized trials. Lung cancer screening research is yielding a relevant body of medical knowledge that will be beneficial for other smoking-related diseases and contribute to a better understanding of lung cancer biology.
Infante
Maurizio V
MV
Department of Thoracic Surgery, Istituto Clinico Humanitas, Rozzano, Milan, Italy. maurizio.infante@humanitas.it
Pedersen
Jesper H
JH
D003362:Cost-Benefit Analysis; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D008403:Mass Screening; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D036542:Tomography, Spiral Computed