Lung cancer screening in never smokers

Area of Science:

• Pulmonology
• Oncology
• Radiology

Background:

• Lung cancer screening with low-dose computed tomography (LDCT) is established for smokers.
• The efficacy and implementation of LDCT screening in never-smokers are less understood.
• Lung cancer biology differs between smokers and never-smokers, necessitating a tailored screening approach.

Purpose of the Study:

• To review emerging data on LDCT screening for lung cancer in never-smokers.
• To identify implementation challenges for LDCT screening in never-smokers.

Main Methods:

• Review of current literature and emerging data on LDCT screening in never-smokers.
• Analysis of lung cancer detection rates and characteristics in never-smoker screening studies.
• Discussion of risk prediction models and nodule management strategies.

Main Results:

• The initial LDCT screening study in high-risk never-smokers showed a lung cancer detection rate twice that of smoker trials.
• Lung cancer risk in Asian female never-smokers detected by LDCT was comparable to male ever-smokers.
• Most lung cancers identified by LDCT screening were early-stage (0/1), raising concerns about overdiagnosis.

Conclusions:

• LDCT screening may be effective in never-smokers with appropriate risk stratification.
• Further global research is required to establish optimal screening strategies and assess health/economic benefits for widespread implementation.