Lung Cancer Screening

Author:
Peter B. Bach From Memorial Sloan-Kettering Cancer Center, New York, New York.

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 MD, MAPP
Volume/Issue:
Volume 6: Issue 3
Online Publication Date:
Mar 2008
DOI:
https://doi.org/10.6004/jnccn.2008.0022
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Because lung cancer frequently presents in an advanced stage when it is incurable, there has been a sustained search for an early diagnosis approach that could detect lung cancer when curable, while having few secondary consequences. Decades of research have evaluated various approaches to lung screening, including routine chest radiograph, sputum cytology, and, most recently, computed tomography (CT) scanning. No study has suggested that any of these approaches will identify life-threatening lung cancers at an earlier disease stage and allow alteration of their natural history. Therefore, no recommending body or professional society recommends using any of these approaches to screen for lung cancer. This general recommendation could change if randomized trials examining CT screening suggest that its benefits outweigh its harms.

Correspondence: Peter B. Bach, MD, MAPP, Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street, 3rd floor, New York, NY 10021. E-mail: bachp@mskcc.org
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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
  • 1.

    Aisner J. CT screening for lung cancer: are we ready for wide-scale application? Clin Cancer Res 2007;13:4951–4953.

  • 2.

    Bach PB, Kelley MJ, Tate RC, McCrory DC. Screening for lung cancer: a review of the current literature. Chest 2003;123(1 Suppl):72S–82S.

  • 3.

    Manser RL, Irving LB, Byrnes G et al.. Screening for lung cancer: a systematic review and meta-analysis of controlled trials. Thorax 2003;58:784–789.

  • 4.

    Strauss GM, Gleason RE, Sugarbaker DJ. Screening for lung cancer re-examined. A reinterpretation of the Mayo Lung Project randomized trial on lung cancer screening. Chest 1993;103(Suppl 4):337S–341S.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Reich JM. Assessing the efficacy of lung cancer screening. Radiology 2006;238:398–401.

  • 6.

    Kubik AK, Parkin DM, Zatloukal P. Czech Study on Lung Cancer Screening: post-trial follow-up of lung cancer deaths up to year 15 since enrollment. Cancer 2000;89(11 Suppl):2363–2368.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Brett GZ. The value of lung cancer detection by six-monthly chest radiographs. Thorax 1968;23:414–420.

  • 8.

    Kubik A, Polak J. Lung cancer detection. Results of a randomized prospective study in Czechoslovakia. Cancer 1986;57:2427–2437.

  • 9.

    Fontana R, Sanderson DR, Woolner LB et al.. Lung cancer screening: the Mayo program. J Occup Med 1986;28:746–750.

  • 10.

    Marcus PM, Bergstralh EJ, Fagerstrom RM et al.. Lung cancer mortality in the Mayo Lung Project: impact of extended follow-up. J Natl Cancer Inst 2000;92:1308–1316.

  • 11.

    Bach PB, Niewoehner DE, Black WC. Screening for lung cancer: the guidelines. Chest 2003;123(1 Suppl):83S–88S.

  • 12.

    Sone S, Takashima S, Li F et al.. Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet 1998;351:1242–1245.

  • 13.

    Swensen SJ, Jett JR, Hartman TE et al.. Lung cancer screening with CT: Mayo Clinic experience. Radiology 2003;226:756–761.

  • 14.

    Pastorino U, Bellomi M, Landoni C et al.. Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results. Lancet 2003;23:593–597.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Diederich S, Wormanns D, Lenzen H et al.. Screening for asymptomatic early bronchogenic carcinoma with low dose CT of the chest. Cancer 2000;89(11 Suppl):2483–2484.

  • 16.

    Henschke CI, McCauley DI, Yankelevitz DF et al.. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 1999;354:99–105.

  • 17.

    Gohagan JK, Marcus PM, Fagerstrom RM et al.. Final results of the Lung Screening Study, a randomized feasibility study of spiral CT versus chest X-ray screening for lung cancer. Lung Cancer 2005;47:9–15.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Sobue T, Moriyama N, Kaneko M et al.. Screening for lung cancer with low-dose helical computed tomography: anti-lung cancer association project. J Clin Oncol 2002;20:911–920.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Henschke CI, Yankelevitz DF, Libby DM et al.. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006;355:1763–1771.

  • 20.

    Bach PB, Jett JR, Pastorino U et al.. Computed tomography screening and lung cancer outcomes. JAMA 2007;297:953–961.

  • 21.

    Blanchon T, Brechot JM, Grenier PA et al.. Baseline results of the Depiscan study: a French randomized pilot trial of lung cancer screening comparing low dose CT scan (LDCT) and chest x-ray (CXR). Lung Cancer 2007;58:50–58.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Patz EF Jr, Swensen SJ, Herndon JE. Estimate of lung cancer mortality from low-dose spiral computed tomography screening trials: implications for current mass screening recommendations. J Clin Oncol 2004;22:2202–2206.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Swensen SJ, Jett JR, Hartman TE et al.. CT screening for lung cancer: five-year prospective experience. Radiology 2005;235:259–265.

  • 24.

    Bach PB, Elkin EB, Pastorino U et al.. Benchmarking lung cancer mortality rates in current and former smokers. Chest 2004;126:1742–1749.

  • 25.

    Bach PB, Begg CB. Further validation of lung cancer mortality model [letter]. Chest Feb 3, 2006.

  • 26.

    Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 2007;298:317–323.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    de Jong PA, Mayo JR, Golmohammadi K et al.. Estimation of cancer mortality associated with repetitive computed tomography scanning. Am J Respir Crit Care Med 2006;173:199–203.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Smith RA, Cokkinides V, Eyre HJ. Cancer screening in the United States, 2007: a review of current guidelines, practices, and prospects. CA Cancer J Clin 2007;57:90–104.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Aberle DR, Gamsu G, Henschke CI et al.. A consensus statement of the Society of Thoracic Radiology: screening for lung cancer with helical computed tomography. J Thorac Imaging 2001;16:65–68.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Bach PB, Silvestri GA, Hanger M, Jett JR. Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007;132(3 Suppl):69S–77S.

Copyright:
Copyright © 2008 by the National Comprehensive Cancer Network
Page Numbers:
5
Article Category:
Research Article
Received:
04 Oct 2007
Accepted:
07 Nov 2007
Print Publication Date:
01 Mar 2008
Online Publication Date:
Mar 2008
Keywords:
Lung cancer screening; low-dose computed tomography; observational studies; randomized controlled trials; chest radiograph; sputum cytology

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