Should we screen for occupational lung cancer with low-dose computed tomography?

The objective of this study was to assess the potential value of screening for occupational lung cancer through the use of low-dose computed tomography (LDCT).

A literature review of Medline was conducted to assess: 1) screening studies of occupational lung cancer that used LDCT; 2) screening studies of nonoccupational lung cancer that used LDCT; and 3) position papers of medical professional societies and nongovernmental health organizations that have addressed the value of screening for lung cancer with LDCT.

No screening studies of occupational lung cancer with LDCT were uncovered; however, numerous observational and population-based studies have addressed the value of screening for lung cancer among cigarette smokers. Results of these studies are difficult to interpret in light of numerous biases associated with these types of studies. No randomized, controlled studies on screening for lung cancer have been published at this time. No professional, governmental, or nonprofit health organization recommends screening asymptomatic people at risk of lung cancer with LDCT at this time.

In the absence of randomized, controlled studies that can address biases commonly encountered in observational and population-based studies, it is unclear whether LDCT reduces mortality from lung cancer. The National Cancer Institute is sponsoring a randomized, controlled study of over 50,000 current and former smokers with the results expected in 2009.