[Screening for lung cancer using CT: time for implementation?]

Screening for lung cancer with computed tomography (CT) appears to be highly effective. A large randomized trial in the United States reported a 7% reduction in all-cause mortality in patients screened by CT in comparison with those screened by chest radiography. The problem of dealing with the large number of pulmonary nodules and false positive test results could be solved by a protocol from the Dutch-Belgian lung cancer screening trial which proposes a strategy based on nodule volume and volumetry. Additional findings related to chronic obstructive pulmonary disease and cardiovascular disease are common in lung cancer screening and may provide an opportunity to increase screening benefits at minimal cost in the future. As CT is superior to radiography in lung cancer detection, CT seems the preferred imaging modality for case finding. As more trial results have to be awaited and cost-effectiveness and optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation.