title: CT screening for lung cancer: countdown to implementation.
abstract: Implementation of lung cancer CT screening is currently the subject of a major policy decision within the USA. Findings of the US National Lung Screening Trial showed a 20% reduction in lung cancer mortality and a 6·7% decrease in all-cause mortality; subsequently, five US professional and clinical organisations and the US Preventive Services Task Force recommended that screening should be implemented. Should national health services in Europe follow suit? The European community awaits mortality and cost-effectiveness data from the NELSON trial in 2015-16 and pooled findings of European trials. In the intervening years, a recommendation is proposed that a demonstration trial is done in the UK. In this Review, we summarise the existing evidence and identify questions that remain to be answered before the implementation of international lung cancer screening programmes.
authors.affiliation: Roy Castle Lung Cancer Research Programme, University of Liverpool Cancer Research Centre, Liverpool, UK. Electronic address: J.K.Field@liv.ac.uk.
authors.forename: John K
authors.initials: JK
authors.lastname: Field
authors.forename: David M
authors.initials: DM
authors.lastname: Hansell
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Duffy
authors.forename: David R
authors.initials: DR
authors.lastname: Baldwin
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000009:adverse effects / Q000191:economics / Q000379:methods / Q000592:standards; D005060:Europe / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D006291:Health Policy; D006801:Humans; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000191:economics / Q000401:mortality*; D008297:Male; D008403:Mass Screening / Q000009:adverse effects / Q000191:economics / Q000379:methods / Q000592:standards; D008875:Middle Aged; D018579:Patient Selection; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000191:economics / Q000379:methods / Q000592:standards; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D019564:Unnecessary Procedures / Q000009:adverse effects*