The rationale for, and design of, a lung cancer screening program.

We are entering a new era in which lung cancer screening may be considered the standard of care. The National Lung Screening Trial (NLST) has shown that the number of deaths due to lung cancer can be reduced through screening with low-dose computed tomography (CT) in a high-risk population (N Engl J Med 2011; 365:395-409). Key issues--such as how to manage lung nodules, how to improve cost-effectiveness, and how to minimize radiation exposure--need to be addressed when designing a lung cancer screening program. Time and further technical advances will help to optimize the programs that are developed.