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Review
. 2025 Jan;35(1):267-275.
doi: 10.1007/s00330-024-10939-6. Epub 2024 Jul 16.

The pros and cons of lung cancer screening

Roberta Eufrasia Ledda  1 , Georg-Christian Funk  2 , Nicola Sverzellati  3
Affiliations
Review

The pros and cons of lung cancer screening

Roberta Eufrasia Ledda et al. Eur Radiol. 2025 Jan.

Abstract

Several trials have shown that low-dose computed tomography-based lung cancer screening (LCS) allows a substantial reduction in lung cancer-related mortality, carrying the potential for other clinical benefits. There are, however, some uncertainties to be clarified and several aspects to be implemented to optimize advantages and minimize the potential harms of LCS. This review summarizes current evidence on LCS, discussing some of the well-established and potential benefits, including lung cancer (LC)-related mortality reduction and opportunity for smoking cessation interventions, as well as the disadvantages of LCS, such as overdiagnosis and overtreatment. CLINICAL RELEVANCE STATEMENT: Different perspectives are provided on LCS based on the updated literature. KEY POINTS: Lung cancer is a leading cancer-related cause of death and screening should reduce associated mortality. This review summarizes current evidence related to LCS. Several aspects need to be implemented to optimize benefits and minimize potential drawbacks of LCS.

Keywords: Benefits and harms; Low-dose computed tomography; Lung cancer screening.

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Conflict of interest statement

Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Roberta Eufrasia Ledda. Conflict of interest: The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. Statistics and biometry: Not applicable. Informed consent: Not applicable. Ethical approval: Institutional Review Board approval was not required because this is a review article. Study subjects or cohorts overlap: Not applicable. Methodology: Review article

Figures

Fig. 1
Fig. 1
Example of a lung adenocarcinoma presenting as a non-solid nodule at baseline LCS low dose computed tomography (A), which developed a solid component at 12-months follow-up (B). A further increase in nodule size and density is shown in C. Nodule size and density for the three-time points are shown in D–F, respectively
Fig. 2
Fig. 2
Graphic representation of the effect of LCS on lung cancer-specific and all-cause mortalities
Fig. 3
Fig. 3
Example of ILA detected on baseline LCS low dose computed tomography (A), with evidence of progression toward over fibrosis at standard dose chest CT (B) performed after 36 months
See this image and copyright information in PMC

References

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