Prospects for population screening and diagnosis of lung cancer

John K. Field*, Matthijs Oudkerk, Jesper Holst Pedersen, Stephen W. Duffy

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    110 Citations (Scopus)

    Abstract

    Deaths from lung cancer exceed those from any other type of malignancy, with 1.5 million deaths in 2010. Prevention and smoking cessation are still the main methods to reduce the death toll. The US National Lung Screening Trial, which compared CT screening with chest radiograph, yielded a mortality advantage of 20% to participants in the CT group. International debate is ongoing about whether sufficient evidence exists to implement CT screening programmes. When questions about effectiveness and cost-effectiveness have been answered, which will await publication of the largest European trial, NELSON, and pooled analysis of European CT screening trials, we discuss the main topics that will need consideration. These unresolved issues are risk prediction models to identify patients for CT screening; radiological protocols that use volumetric analysis for indeterminate nodules; options for surgical resection of CT-identified nodules; screening interval; and duration of screening. We suggest that a demonstration project of biennial screening over a 4-year period should be undertaken.

    Original languageEnglish
    Pages (from-to)732-741
    Number of pages10
    JournalLANCET
    Volume382
    Issue number9893
    Publication statusPublished - 24-Aug-2013

    Keywords

    • RISK PREDICTION MODEL
    • COMPUTED-TOMOGRAPHY
    • SELECTION CRITERIA
    • AFRICAN-AMERICANS
    • PULMONARY NODULES
    • THORACIC-SURGERY
    • RANDOMIZED-TRIAL
    • INDIVIDUAL RISK
    • HEAVY SMOKERS
    • DANTE TRIAL

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