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Review
. 2023 Jul 1;29(4):232-238.
doi: 10.1097/MCP.0000000000000974. Epub 2023 May 16.

Impact of low-dose computed tomography screening on lung cancer incidence and outcomes

Anil Vachani  1   2 , Christopher Caruso  1
Affiliations
Review

Impact of low-dose computed tomography screening on lung cancer incidence and outcomes

Anil Vachani et al. Curr Opin Pulm Med. .

Abstract

Purpose of review: To review findings from clinical trials of lung cancer screening (LCS), assess contemporary issues with implementation in clinical practice, and review emerging strategies to increase the uptake and efficiency of LCS.

Recent findings: In 2013, the USPSTF recommended annual screening for individuals aged 55-80 years and currently smoke or quit within the past 15 years based on reduced mortality from lung cancer with annual low-dose computed tomography (LDCT) screening in the National Lung Screening Trial. Subsequent trials have demonstrated similar mortality outcomes in individuals with lower pack-year smoking histories. These findings, coupled with evidence for disparities in screening eligibility by race, resulted in updated guidelines by USPSTF to broaden eligibility criteria for screening. Despite this body of evidence, implementation in the United States has been suboptimal with fewer than 20% of eligible individuals receiving a screen. Barriers to efficient implementation are multifactorial and include patient, clinician, and system-level factors.

Summary: Multiple randomized trials have established that annual LCS reduces mortality from lung cancer; however, several areas of uncertainty exist on the effectiveness of annual LDCT. Ongoing research is examining approaches to improve the uptake and efficiency of LCS, such as the use of risk-prediction models and biomarkers for identification of high-risk individuals.

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Conflict of interest statement

Conflict of Interest: Anil Vachani reports personal fees as a scientific advisor to the Lung Cancer Initiative at Johnson & Johnson and grants to his institution from MagArray, Inc., Broncus Medical, Inc., and Precyte, Inc. outside of the submitted work. Dr. Vachani is an advisory board member of the Lungevity Foundation (unpaid).

Figures

Figure 1.
Figure 1.
Barriers listed summarized from Carter-Harris, et al.(31) and Cavers, et al.(34)
See this image and copyright information in PMC

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