title: Lung cancer screening: advantages, controversies, and applications.
abstract: BACKGROUND
  Lung cancer is the leading cause of cancer death in the United States. Results from the National Lung Screening Trial (NLST) have shown that low-dose computed tomography (CT) is capable of detecting lung neoplasms in individuals at high risk. However, whether it is advantageous to perform lung cancer screening on these patients is a significant concern, as are the potential adverse outcomes from screening.
  
  
  METHODS
  A review of several randomized clinical trials, focusing on the NLST, was undertaken. Adverse outcomes and costs related to lung cancer screening were also examined.
  
  
  RESULTS
  Lung cancer screening using low-dose CT in high-risk individuals reduced lung cancer deaths by more than 20% when compared with those screened by chest radiography. False-positive results were seen in both groups, but the number of adverse events from the screening test and subsequent diagnostic procedures was low.
  
  
  CONCLUSIONS
  Lung cancer screening is controversial, but the NLST has demonstrated that such testing may reduce lung cancer deaths in high-risk individuals when performed with low-dose CT rather than chest radiography. Guidelines should be established to not only help identify an appropriate screening population, but also develop standards for radiological testing.
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA. Michael.Alberts@Moffitt.org.
authors.forename: Prema
authors.initials: P
authors.lastname: Nanavaty
authors.forename: Michael S
authors.initials: MS
authors.lastname: Alvarez
authors.forename: W Michael
authors.initials: WM
authors.lastname: Alberts
mesh_terms: D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000191:economics / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000379:methods