Lung Cancer Screening With Low-Dose CT: A Systematic Review

Area of Science:

• Oncology
• Public Health
• Radiology

Background:

• Lung cancer is a leading cause of cancer mortality globally and in Portugal.
• Low-dose computed tomography (LDCT) screening shows potential for reducing lung cancer mortality.
• Few countries have implemented lung cancer screening strategies.

Purpose of the Study:

• To review existing evidence on the effectiveness and relevance of implementing lung cancer screening programs.
• To assess the impact of LDCT screening on lung cancer mortality.
• To identify uncertainties in current screening strategies.

Main Methods:

• Systematic search for clinical practice guidelines, systematic reviews, meta-analyses, and randomized controlled trials published between 2010 and 2024.
• Databases searched include PubMed, Cochrane Library, and others.
• Evaluation of evidence using the Strength of Recommendation Taxonomy (SORT).

Main Results:

• Clinical practice guidelines recommend LDCT screening for individuals aged 50-80 with a 20+ pack-year smoking history.
• Meta-analyses and systematic reviews demonstrate a statistically significant reduction in lung cancer mortality, but not all-cause mortality.
• Heterogeneity exists regarding optimal age ranges and follow-up periods; overdiagnosis rates vary.

Conclusions:

• LDCT lung cancer screening effectively reduces disease-specific mortality.
• Implementing organized screening for at-risk populations could yield significant public health benefits.
• Further research is needed to refine optimal screening strategies and address remaining uncertainties.