Sensitivity and specificity of chest X-ray screening for lung cancer: review article.

BACKGROUND: The incidence and mortality rates of lung carcinoma have been increasing during the last years. Despite this, medical public policy holds that chest X-ray screening is ineffective in the early detection of lung carcinoma.
METHODS: The authors reviewed the most important studies published in the literature regarding the role of chest X-ray screening in the early diagnosis of lung carcinoma in a high risk population. None of the four randomized, controlled trials on lung carcinoma screening conducted in male cigarette smokers demonstrated a reduction in the mortality rate. Accordingly, no organization that formulates screening policy advocates any specific early detection strategies for lung carcinoma.
RESULTS: A careful analysis of randomized, controlled trials showed that there was no improvement in the mortality rate in the screened populations, but there is considerable evidence that chest X-ray screening is associated with earlier detection and improved survival.
CONCLUSIONS: In the authors' opinion, the considerable improvements in distribution by disease stage, tumor resectability, and patient survival in the screened groups demonstrate the effectiveness of chest X-ray screening in the early detection of lung carcinoma. The authors conclude that radiographic screening is the only valid method of secondary prevention in cigarette smokers.