[Early diagnosis of lung cancer: where do we stand?]

Screening studies involving chest x-rays with and without additional sputum cytology, have failed to bring about any reduction in mortality from lung cancer. With regard to all other potential screening methods, no studies investigating tumor-specific mortality are available. Against such a background, none of the relevant societies recommend systematic screening. Sputum cytology is sensitive only for central lesions. Autofluorescence bronchoscopy is limited to the detection of early malignant and premalignant lesions in the central airways. While CT screening detects numerous round foci, only a few of these prove to be carcinomas. In contrast to these findings, we have the positive results of non-controlled screening studies employing low-dose CT, which, however, has not been widely accepted.