Screening for lung cancer.
OBJECTIVE
The purpose of this review is to provide an update on the current data about low-dose computed tomography (LD-CT) lung cancer screening.


RESULTS
The National Lung Screening Trial (NLST) was the first study that provided statistical evidence that LD-CT screening for lung cancer significantly reduces lung cancer mortality by 20%. Three statistically underpowered European trials could not confirm the positive effect of LD-CT screening on lung cancer mortality. Major obstacles in lung cancer screening are overdiagnosis and the large number of false-positive results. In the NLST, more than 24% of the screens were positive, most of which (96.4%) proved to be benign in nature. Optimized protocols for the workup of detected nodules may help to reduce the number of false-positive screens.


CONCLUSIONS
Currently, the NLST is the only sufficiently powered trial to report a lower mortality rate with LD-CT screening. Long-term follow-up data are still anticipated on the European screening trials. Furthermore, data on the extent of the potential dangers of LD-CT screening, such as overdiagnosis, false-positive results, and the effect of cumulative radiation dose, have yet to be investigated thoroughly.
aDepartment of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria bRadiologie, Meander Medical Center, Ameersfoort und Radboud Universitaet, Nijmegen, the Netherlands.
Helmut
H
Prosch
Cornelia
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Schaefer-Prokop
D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality; D008403:Mass Screening / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed