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Review
. 2014 Mar;26(2):131-7.
doi: 10.1097/CCO.0000000000000055.

Screening for lung cancer

Helmut Prosch  1 , Cornelia Schaefer-Prokop
Affiliations
Review

Screening for lung cancer

Helmut Prosch et al. Curr Opin Oncol. 2014 Mar.

Abstract

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

Recent findings: 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.

Summary: 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.

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