Lung cancer screening: examining the issues

Cleve Clin J Med. 2012 May;79 Electronic Suppl 1:eS1-6. doi: 10.3949/ccjm.79.s2.01.


The goal of screening is to detect disease at a stage when cure or control is possible, thereby decreasing disease-specific deaths in the population. Many studies have attempted to demonstrate that lung cancer screening using chest radiography or computed tomography (CT) identifies patients with lung cancer and reduces cancer-related mortality. Until recently, there was no evidence confirming a reduction in disease-specific mortality with screening. Early cancer screening should result in a gradual population-wide stage shift toward earlier cancer stages over time, but stage shifting was not reported in early lung cancer screening studies. Lead-time, length-time, and overdiagnosis biases may each have an impact on screening studies reporting survival as an outcome. In this past year, the National Lung Screening Trial reported a significant reduction in cancer-related mortality as a result of screening with chest CT imaging. This will shape the direction of future screening programs.

Publication types

  • Review

MeSH terms

  • Cost-Benefit Analysis
  • Early Detection of Cancer* / adverse effects
  • Early Detection of Cancer* / economics
  • Early Detection of Cancer* / trends
  • False Positive Reactions
  • Forecasting
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / mortality
  • Mass Screening* / economics
  • Mass Screening* / methods
  • Tomography, X-Ray Computed / adverse effects
  • Tomography, X-Ray Computed / economics