title: Lung cancer screening: a systematic review of clinical practice guidelines.
abstract: BACKGROUND
  Lung cancer screening using low-dose computed tomography presents an exciting development for high-risk individuals. Several expert bodies and governments have recently issued and updated their clinical practice guidelines (CPGs) for lung cancer screening. We evaluate the CPGs and compare and contrast the recommendations between them.
  
  
  METHODS
  We searched seven databases (MEDLINE, EMBASE, TRIP, NGC, SIGN, GIN, CMA Infobase) to find CPGs, and used the appraisal of guidelines for research and evaluation instrument (AGREE-II) to evaluate them. We also assessed the recommendations within each CPG.
  
  
  RESULTS
  Of the eight CPGs included, four guidelines were regarded as high in quality (60%) based on rigour of development and effectively targeting 4-5 of the six domains according to the AGREE-II criteria. Most CPGs' recommendations for the lung cancer screening of high-risk individuals, the associated screening parameters and the benefit vs. harm of screening were consistent. However, there is still variation among the CPGs reviewed in this study.
  
  
  CONCLUSIONS
  The qualities of the selected CPGs vary and there is potential to improve the qualities among and between each. Specifically, more evidence is needed to support the recommendations such as a larger cohort of high-risk participants, and further analysis of the lung cancer screening interval, the benefit vs. harm of lung cancer screening, the timing and rigour of follow-up and availability of effective treatments.
authors.affiliation: Department of Thoracic Surgery, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Li
authors.affiliation: Department of Research and Education, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: L
authors.initials: L
authors.lastname: Luo
authors.affiliation: Department of Research and Education, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: Y H
authors.initials: YH
authors.lastname: Hu
authors.affiliation: Department of Research and Education, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Research and Education, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: Y K
authors.initials: YK
authors.lastname: Den
authors.affiliation: Department of Medical Imaging, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: L
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Thoracic Surgery, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: B
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: D
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Respiratory Medicine, Guizhou Province People's Hospital, Guiyang, China.
authors.forename: X Y
authors.initials: XY
authors.lastname: Zhang
mesh_terms: D055088:Early Detection of Cancer; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards*; D011829:Radiation Dosage; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*