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

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.

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.

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.

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.