Lung cancer screening: has there been any progress? Computed tomography and autofluorescence bronchoscopy

Area of Science:

• Pulmonology
• Radiology
• Oncology

Background:

• Lung cancer screening aims to reduce morbidity and mortality through early detection and intervention.
• Advances in imaging technologies are crucial for achieving a stage shift in lung cancer diagnosis.

Purpose of the Study:

• To review recent publications on lung cancer screening technologies.
• To evaluate the effectiveness and cost-effectiveness of current lung cancer screening methods.

Main Methods:

• Review of recent important publications on lung cancer screening.
• Analysis of imaging technologies including autofluorescence bronchoscopy, multidetector computed tomography (CT), and CT-positron emission tomography.

Main Results:

• Autofluorescence bronchoscopy is effective for early central airway lesions.
• Multidetector CT and CT-PET aid in diagnosing early parenchymal lung lesions.
• Screening cost-effectiveness is undermined by lead-time, length-time, and overdiagnosis biases, alongside low test specificity.

Conclusions:

• Advanced imaging enables early lung cancer detection and intervention in select individuals.
• High costs and the need to screen many at-risk individuals to find few cancers challenge stage shift attainment.
• Screening efficacy may be reduced by comorbidities and practical hurdles; lung cancer is not the ultimate cause of death for most smokers, even with advanced screening technologies.