[Lung cancer screening - an overview about chances and risks]

Area of Science:

• Oncology
• Pulmonology
• Radiology

Context:

• Lung cancer is a major global cause of mortality, often diagnosed at advanced stages.
• Switzerland faces high lung cancer death rates, emphasizing the need for effective prevention and screening.
• Current prevention strategies focus on smoking cessation and preventing initiation.

Purpose:

• To evaluate the effectiveness of routine lung cancer screening in smokers.
• To summarize evidence from recent randomized controlled trials on lung cancer screening methods.
• To assess the mortality reduction benefits of low-dose computed tomography (LDCT) versus conventional methods.

Summary:

• Five randomized controlled trials on lung cancer screening in smokers were reviewed.
• Conventional chest X-rays showed no mortality benefit compared to usual care.
• Low-dose computed tomography (LDCT) demonstrated a significant mortality reduction only in the US National Lung Screening Trial (NLST).
• Three European trials using LDCT did not confirm these benefits, questioning generalizability.
• LDCT screening resulted in a high false-positive rate and significant resource utilization for diagnostic work-ups.

Impact:

• The effectiveness of LDCT screening for reducing lung cancer mortality remains debated, particularly in European populations.
• High false-positive rates and resource demands necessitate further investigation into the cost-effectiveness of LDCT screening.
• Findings highlight the need for careful consideration of screening protocols and population-specific evidence.