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Low-dose CT screening may benefit individuals at increased risk for lung cancer
Date:5/20/2012

Peter B. Bach, M.D., of the Memorial Sloan-Kettering Cancer Center, New York, and colleagues conducted a systematic review to examine the evidence regarding the benefits and harms of low-dose computerized tomography (LDCT) screening for lung cancer, which is the leading cause of cancer death. "Most patients are diagnosed with advanced disease, resulting in a very low 5-year survival rate," the authors write. "Renewed enthusiasm for lung screening arose with the advent of LDCT imaging, which is able to identify smaller nodules than can chest radiographs."

For the review, the researchers identified 8 randomized controlled trials and 13 cohort studies of LDCT screening that met criteria for inclusion. Three randomized studies provided evidence on the effect of LDCT screening on lung cancer mortality, of which the National Lung Screening Trial was the most informative, demonstrating that among 53,454 participants enrolled, screening resulted in significantly fewer lung cancer deaths (20 percent lower relative risk). The other 2 smaller studies showed no such benefit. "In terms of potential harms of LDCT screening, across all trials and cohorts, approximately 20 percent of individuals in each round of screening had positive results requiring some degree of follow-up, while approximately 1 percent had lung cancer. There was marked heterogeneity in this finding and in the frequency of follow-up investigations, biopsies, and percentage of surgical procedures performed in patients with benign lesions." The authors write that "Low-dose computed tomography screening may benefit individuals at an increased risk for lung cancer, but uncertainty exists about the potential harms of screening and the generalizability of results."

This report, a multisociety collaborative initiative, forms the basis of the American College of Chest Physicians and the American Society of Clinical Oncology clinical practice guideline, which, in summary is:

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Contact: Jeanne D'Agostino
dagostij@mskcc.org
212-639-3573
JAMA and Archives Journals
Source:Eurekalert

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