Timing of Screening Benefit for Lung Cancer With Low-Dose CT Imaging

Area of Science:

• Pulmonology
• Radiology
• Oncology

Background:

• Lung cancer screening with low-dose CT (LDCT) is increasingly supported.
• The benefits of LDCT screening may not be immediate.
• LDCT screening is unlikely to benefit patients with limited life expectancy.

Purpose of the Study:

• To determine the time to benefit (TTB) from LDCT screening for individuals at high risk for lung cancer.

Main Methods:

• Systematic search of PubMed for population-based, randomized controlled trials of lung cancer screening using LDCT.
• Estimation of TTB using an established analysis framework for the National Lung Screening Trial (NLST) and pooled data from four trials.

Main Results:

• Analysis included four trials with 64,105 participants.
• In the NLST, preventing one lung cancer death required screening 2,000 individuals over 1.78 years.
• Preventing one death required 2.87 to 8.87 years of screening for every 1,000 to 200 individuals, respectively.

Conclusions:

• Clinical benefits of LDCT screening may not be suitable for individuals with limited life expectancy.
• Integrating TTB estimates into patient selection can help maximize LDCT screening benefits.