[Lung cancer screening with low dose computed tomography : a systematic review]

Area of Science:

• Pulmonology
• Oncology
• Radiology

Background:

• Bronchial cancer is a leading cause of cancer death, often diagnosed late.
• Early detection via screening may enable curative treatment.
• Low-dose chest computed tomography (LDCT) is evaluated for lung cancer screening.

Purpose of the Study:

• To determine the impact of LDCT screening on overall mortality in a smoking population.
• To synthesize evidence from randomized controlled screening trials.

Main Methods:

• Systematic review of randomized controlled trials.
• Comparison of LDCT screening versus no screening or chest X-ray.
• Analysis of mortality outcomes from identified trials.

Main Results:

• Seven trials reported mortality results, including NSLT, NELSON, LUSI, and MILD.
• NSLT showed a 6.7% reduction in overall mortality and 20% in lung cancer mortality.
• Significant reductions in lung cancer mortality were observed in NELSON (24% in men), LUSI (69% in women), and MILD (39%).

Conclusions:

• LDCT screening demonstrates potential for reducing lung cancer mortality.
• Further clarification is needed on individual selection, positive result definition, and nodule management.
• Screening for bronchial cancer remains a complex issue requiring refined protocols.