title: Lung cancer screening: examining the issues.
abstract: The goal of screening is to detect disease at a stage when cure or control is possible, thereby decreasing disease-specific deaths in the population. Many studies have attempted to demonstrate that lung cancer screening using chest radiography or computed tomography (CT) identifies patients with lung cancer and reduces cancer-related mortality. Until recently, there was no evidence confirming a reduction in disease-specific mortality with screening. Early cancer screening should result in a gradual population-wide stage shift toward earlier cancer stages over time, but stage shifting was not reported in early lung cancer screening studies. Lead-time, length-time, and overdiagnosis biases may each have an impact on screening studies reporting survival as an outcome. In this past year, the National Lung Screening Trial reported a significant reduction in cancer-related mortality as a result of screening with chest CT imaging. This will shape the direction of future screening programs.
authors.affiliation: Critical Care Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. mazzonp@ccf.org
authors.forename: Peter
authors.initials: P
authors.lastname: Mazzone
mesh_terms: D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000009:adverse effects / Q000191:economics / Q000639:trends; D005189:False Positive Reactions; D005544:Forecasting; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality; D008403:Mass Screening / Q000191:economics / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000191:economics