[Lung cancer screening - risk stratification : Who should undergo screening?]

Lung cancer is one of the leading causes of deaths in Europa and the USA. In approximately 75 % of lung cancer patients, bronchogenic carcinoma is detected at an advanced tumor stage; therefore, therapeutic options which aim at curing the disease in these patients are limited and treatment is mostly palliative. A relatively good prognosis is reserved for the minority of patients where the tumor is detected at an early stage and treatment is potentially curative. For this reason, early diagnosis of lung cancer could save lives. Retrospective analyses of the US national lung screening trial (NLST) showed that especially high-risk populations (e. g. higher age, positive smoking history, overweight and a positive family history for lung cancer) benefit most from lung cancer screening. Thus, the effectiveness of computed tomography (CT) screening can be improved by focusing on high-risk populations. This review article summarizes the risk stratification models of the large European and American screening studies and discusses possible future biomarkers for risk stratification.