Helmut Prosch1, Cornelia Schaefer-Prokop. 1. aDepartment of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria bRadiologie, Meander Medical Center, Ameersfoort und Radboud Universitaet, Nijmegen, the Netherlands.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the current data about low-dose computed tomography (LD-CT) lung cancer screening. RECENT FINDINGS: The National Lung Screening Trial (NLST) was the first study that provided statistical evidence that LD-CT screening for lung cancer significantly reduces lung cancer mortality by 20%. Three statistically underpowered European trials could not confirm the positive effect of LD-CT screening on lung cancer mortality. Major obstacles in lung cancer screening are overdiagnosis and the large number of false-positive results. In the NLST, more than 24% of the screens were positive, most of which (96.4%) proved to be benign in nature. Optimized protocols for the workup of detected nodules may help to reduce the number of false-positive screens. SUMMARY: Currently, the NLST is the only sufficiently powered trial to report a lower mortality rate with LD-CT screening. Long-term follow-up data are still anticipated on the European screening trials. Furthermore, data on the extent of the potential dangers of LD-CT screening, such as overdiagnosis, false-positive results, and the effect of cumulative radiation dose, have yet to be investigated thoroughly.
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the current data about low-dose computed tomography (LD-CT) lung cancer screening. RECENT FINDINGS: The National Lung Screening Trial (NLST) was the first study that provided statistical evidence that LD-CT screening for lung cancer significantly reduces lung cancer mortality by 20%. Three statistically underpowered European trials could not confirm the positive effect of LD-CT screening on lung cancer mortality. Major obstacles in lung cancer screening are overdiagnosis and the large number of false-positive results. In the NLST, more than 24% of the screens were positive, most of which (96.4%) proved to be benign in nature. Optimized protocols for the workup of detected nodules may help to reduce the number of false-positive screens. SUMMARY: Currently, the NLST is the only sufficiently powered trial to report a lower mortality rate with LD-CT screening. Long-term follow-up data are still anticipated on the European screening trials. Furthermore, data on the extent of the potential dangers of LD-CT screening, such as overdiagnosis, false-positive results, and the effect of cumulative radiation dose, have yet to be investigated thoroughly.
Authors: Douglas E Wood; Ella A Kazerooni; Scott L Baum; George A Eapen; David S Ettinger; Lifang Hou; David M Jackman; Donald Klippenstein; Rohit Kumar; Rudy P Lackner; Lorriana E Leard; Inga T Lennes; Ann N C Leung; Samir S Makani; Pierre P Massion; Peter Mazzone; Robert E Merritt; Bryan F Meyers; David E Midthun; Sudhakar Pipavath; Christie Pratt; Chakravarthy Reddy; Mary E Reid; Arnold J Rotter; Peter B Sachs; Matthew B Schabath; Mark L Schiebler; Betty C Tong; William D Travis; Benjamin Wei; Stephen C Yang; Kristina M Gregory; Miranda Hughes Journal: J Natl Compr Canc Netw Date: 2018-04 Impact factor: 11.908
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