Lung cancer screening

Abstract

Lung cancer kills more people than any other cancer. Prevention and smoking cessation remains the prime methods to reduce this death toll. The US National Lung Screening Trial (NLST), comparing computed tomography (CT) screening with chest X-ray, yielded a 20 % mortality advantage to individuals in the CT arm. The US Preventive Services Task Force have recommended the implementation of lung cancer screening in individuals of 55 to 80 year of age, based on the NLST selection criteria. However, there is currently an international debate on the how to implement lung cancer screening. Questions on cost-effectiveness need to been answered satisfactorily. The other major outstanding questions which need to be considered are focused on, in this chapter: risk prediction models to identify individuals for CT screening programmes; radiological protocols which utilise volumetric analysis for indeterminate nodules; screening interval and duration of screening. In Europe we need to prepare for lung cancer screening with an integrated smoking cessation policy, as this combined approach will save more lives than any other lung cancer intervention in the near future.