Issues with implementing a high-quality lung cancer screening program

Abstract

After a comprehensive review of the evidence, the United States Preventive Services Task Force recently endorsed screening with low-dose computed tomography as an early detection approach that has the potential to significantly reduce deaths due to lung cancer. Prudent implementation of lung cancer screening as a high-quality preventive health service is a complex challenge. The clinical evaluation and management of high-risk cohorts in the absence of symptoms mandates an approach that differs significantly from that of symptom-detected lung cancer. As with other cancer screenings, it is essential to provide to informed at-risk individuals a safe, high-quality, cost-effective, and accessible service. In this review, the components of a successful screening program are discussed as we begin to disseminate lung cancer screening as a national resource to improve outcomes with this lethal cancer. This information about lung cancer screening will assist clinicians with communications about the potential benefits and harms of this service for high-risk individuals considering participation in the screening process.

Keywords: American Academy of Family Physicians (AAFP); American Association of Physicists in Medicine (AAPM); Centers for Medicaid and Medicare Services (CMS); National Lung Screening Trial (NLST); Nederlands-Leuvens Longkanker Screenings ONderzoek (NELSON) trial; Prostate, Lung, Colorectal, and Ovarian (PLCO) Screening Trial; US Preventive Services Task Force (USPSTF).; chest x-ray (CXR); low-dose computed tomography (LDCT); lung cancer screening.