Adenocarcinoma of the lung screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

According to the U.S. Preventive Services Task Force (USPSTF), screening for lung cancer by low-dose computed tomography (LDCT) is recommended every year among smokers and former smokers who are between 55 to 80 years old and who have smoked 30 pack-years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation). According to the clinical practice guideline issued by the American College of Chest Physicians (CHEST) in 2013, screening for lung cancer by low-dose CT (LDCT) is recommended every year among smokers and former smokers who are age 55 to 74 and who have smoked for 30 pack-years or more and either continue to smoke or have quit within the past 15 years.

Screening

Guidelines

• According to the U.S. Preventive Services Task Force (USPSTF), screening for lung cancer by low-dose computed tomography (LDCT) is recommended every year among smokers and former smokers who are between 55 to 80 years old and who have smoked 30 pack-years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation).

• According to the American College of Chest Physicians (CHEST) in 2013, screening for lung cancer by low-dose CT (LDCT) is recommended every year among smokers and former smokers who are age 55 to 74 and who have smoked for 30 pack-years or more and either continue to smoke or have quit within the past 15 years.

Strategies

• Low-dose helical computed tomography:

• Advantages:

• There is evidence that screening 55 to 74 year old smokers of 30 or more pack-years or former smokers, who have quit within the last 15 years, reduces lung cancer mortality by 20% and all-cause mortality by 6.7%.

• Diasdvantages:

• At least 98% of all positive low-dose helical computed tomography screening exams do not result in a lung cancer diagnosis.
• False-positive exams may result in unnecessary invasive diagnostic procedures.

• Chest x-ray and/or sputum cytology:

• Advantages:

• Screening with chest x-ray and/or sputum cytology has no role in reducing mortality from lung cancer in the general population.

• Disadvantages:

• False positive exams
• At least 95% of all positive chest x-ray screening exams do not result in a lung cancer diagnosis.
• False-positive exams result in unnecessary invasive diagnostic procedures.

References

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