Lung Cancer Screening in High-Risk Patients with Low-Dose Helical CT

Abstract

Lung cancer is the leading cause of cancer death worldwide. Most patients are diagnosed at a late stage because of lack of symptoms in early stage disease, resulting in a very low 5-year survival. Effective screening methods for early detection of lung cancer are very important, especially for high-risk groups (such as current or former smokers). Early randomized trials used chest radiograph, but did not show any difference in lung cancer incidence or mortality between the control group and the experimental group. With recent data released from the NLST that demonstrate a statistically significant reduction (20 %) in lung cancer deaths in patients screened with LDCT scans, many societies suggest annual screening with low-dose CT in high-risk individuals for lung cancer. Questions still remain about the harms from false-positive results, overdiagnosis, the costs, and the effect on quality of life. Before public health policy decisions are taken, it must be rigorously analyzed the cost-effectiveness of low-dose CT screening.