Pulmonary nodule screening: Difference between revisions
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==Overview== | ==Overview== | ||
According to the U.S. Preventive Services Task Force (USPSTF), screening for suspected lung cancer by low-dose computed tomography is recommended every year among smokers who are between 55 to 80 years old and who have history of | According to the U.S. Preventive Services Task Force (USPSTF), [[Screening (medicine)|screening]] for suspected [[lung cancer]] by low-dose [[computed tomography]] is recommended every year among [[Smoking|smokers]] who are between 55 to 80 years old and who have [[smoking]] history of 30 [[Pack year|pack years]] or more and either continue to [[Smoking|smoke]] or have quit within the past 15 years (grade B recommendation). | ||
==Screening== | ==Screening== | ||
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'''Guidelines''' | '''Guidelines''' | ||
*According to the U.S. Preventive Services Task Force (USPSTF), screening for suspected lung cancer by low-dose computed tomography is recommended every year among smokers who are between 55 to 80 years old and who have history of | *According to the U.S. Preventive Services Task Force (USPSTF), [[Screening (medicine)|screening]] for suspected [[lung cancer]] by low-dose [[computed tomography]] is recommended every year among [[Smoking|smokers]] who are between 55 to 80 years old and who have [[smoking]] history of 30 [[Pack year|pack years]] or more and either continue to [[Smoking|smoke]] or have quit within the past 15 years (grade B recommendation).<ref name="“lung" screen"="">Lung Cancer: Screening http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening. Accessed on February 3, 2016 </ref><ref name="“JAMA”">Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.</ref><ref name="“ludng"">National Lung Screening Trial. Wikipedia. https://en.wikipedia.org/wiki/National_Lung_Screening_Trial Accessed on February 4,2016</ref><ref name="US">Recommendations. US preventive services task force(2016) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=solitary_pulmonary_nodule Accessed on March, 15th 2016</ref><ref name="NEJM">McWilliams A, Tammemagi MC, Mayo JR, et. al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med. 2013 Sep 5;369(10):910-9. doi:10.1056/NEJMoa1214726.</ref> | ||
* According to the [[clinical practice guideline]] issued by the [[American College of Chest Physicians]] (CHEST) in 2013, screening for suspected lung cancer by low-dose CT (LDCT) is recommended every year among smokers and former smokers who are | * According to the [[clinical practice guideline]] issued by the [[American College of Chest Physicians]] (CHEST) in 2013, [[Screening (medicine)|screening]] for suspected [[lung cancer]] by low-dose [[Computed tomography|CT]] (LDCT) is recommended every year among smokers and former smokers who are 55 to 74 years old and who have [[Smoking|smoked]] for 30 years or more and either continue to [[Smoking|smoke]] or have quit within the past 15 years.<ref name="pmid23649455">{{cite journal| author=Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB| title=Screening for Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2013 | volume= 143 | issue= 5 Suppl | pages= e78S-92S | pmid=23649455 | doi=10.1378/chest.12-2350 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23649455 }} [http://general-medicine.jwatch.org/cgi/content/full/2013/522/2 Summary in JournalWatch]</ref> | ||
'''Strategies''' | '''Strategies''' | ||
* Low-dose helical computed tomography<ref name="lungscreen">Lung Cancer Screening. National Cancer Institute 2015. http://www.cancer.gov/types/lung/hp/lung-screening-pdq Accessed on December 20, 2015</ref> | * Low-dose helical [[computed tomography]]<ref name="lungscreen">Lung Cancer Screening. National Cancer Institute 2015. http://www.cancer.gov/types/lung/hp/lung-screening-pdq Accessed on December 20, 2015</ref> | ||
:* Benefits | :* Benefits | ||
::* There is evidence that screening | ::* There is evidence that [[Screening (medicine)|screening]] individuals aged 55 to 74 years who have smoking histories of 30 or more [[Pack year|pack years]] and who, if they are former smokers, have quit within the last 15 years, reduces [[lung cancer]] [[Mortality rate|mortality]] by 20% and all-cause [[mortality]] by 6.7%. | ||
:* Harms | :* Harms | ||
::* The majority of of all positive low-dose helical computed tomography screening exams do not result in a lung cancer diagnosis. | ::* The majority of of all positive low-dose helical [[computed tomography]] [[Screening (medicine)|screening]] exams do not result in a [[lung cancer]] [[diagnosis]]. | ||
::* False-positive exams may result in unnecessary invasive diagnostic procedures. | ::*[[False-positive test result|False-positive]] exams may result in unnecessary [[Invasive (medical)|invasive]] [[diagnostic procedures]]. | ||
* Chest x-ray <ref name="JAMA">Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.</ref> | * Chest x-ray <ref name="JAMA">Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.</ref> | ||
:*Benefits | :*Benefits | ||
::*Screening with chest x-ray does not reduce mortality from lung cancer in the general population or in ever-smokers. | ::*[[Screening (medicine)|Screening]] with [[Chest X-ray|chest x-ray]] does not reduce [[mortality]] from [[lung cancer]] in the general population or in ever-smokers. | ||
:* Harms | :* Harms | ||
::* False positive | ::*[[False positive|False positive result]] | ||
::* The majority of of all positive chest x-ray screening exams do not result in a lung cancer diagnosis. | ::* The majority of of all positive [[Chest X-ray|chest x-ray]] [[Screening (medicine)|screening]] exams do not result in a [[lung cancer]] [[diagnosis]]. | ||
::* False-positive exams result in unnecessary invasive diagnostic procedures. | ::*[[False-positive]] exams result in unnecessary [[Invasive (medical)|invasive]] [[diagnostic procedures]]. | ||
'''Overdiagnosis''' | '''Overdiagnosis''' | ||
* Based on current evidence, the majority of solitary pulmonary nodules detected by screening chest x-ray appear to represent | * Based on the current evidence, the majority of solitary pulmonary nodules detected by [[Screening (medicine)|screening]] [[Chest X-ray|chest x-ray]] appear to represent [[Overdiagnosis|overdiagnosed]] [[cancer]].<ref name="JAMA">Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.</ref> | ||
*The magnitude of overdiagnosis appears to be between 5% and 25%. | *The magnitude of [[overdiagnosis]] appears to be between 5% and 25%. | ||
*These cancers result in unnecessary diagnostic procedures and also lead to unnecessary treatment. | *These [[Cancer|cancers]] result in unnecessary [[Diagnosis|diagnostic procedures]] and also lead to unnecessary treatment. | ||
*Harms of diagnostic procedures and treatment occur most frequently among long-term and/or heavy smokers because of smoking-associated comorbidities that increase risk propagation. | *Harms of [[diagnostic procedures]] and treatment occur most frequently among long-term and/or heavy smokers because of smoking-associated [[Comorbidity|comorbidities]] that increase risk propagation. | ||
==References== | ==References== | ||
Latest revision as of 17:00, 28 June 2019
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Pulmonary Nodule Microchapters |
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Case Studies |
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Pulmonary nodule screening On the Web |
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American Roentgen Ray Society Images of Pulmonary nodule screening |
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Risk calculators and risk factors for Pulmonary nodule screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
According to the U.S. Preventive Services Task Force (USPSTF), screening for suspected lung cancer by low-dose computed tomography is recommended every year among smokers who are between 55 to 80 years old and who have smoking history of 30 pack years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation).
Screening
Guidelines
- According to the U.S. Preventive Services Task Force (USPSTF), screening for suspected lung cancer by low-dose computed tomography is recommended every year among smokers who are between 55 to 80 years old and who have smoking history of 30 pack years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation).[1][2][3][4][5]
- According to the clinical practice guideline issued by the American College of Chest Physicians (CHEST) in 2013, screening for suspected lung cancer by low-dose CT (LDCT) is recommended every year among smokers and former smokers who are 55 to 74 years old and who have smoked for 30 years or more and either continue to smoke or have quit within the past 15 years.[6]
Strategies
- Low-dose helical computed tomography[7]
- Benefits
- There is evidence that screening individuals aged 55 to 74 years who have smoking histories of 30 or more pack years and who, if they are former smokers, have quit within the last 15 years, reduces lung cancer mortality by 20% and all-cause mortality by 6.7%.
- Harms
- The majority of 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 [8]
- Benefits
- Screening with chest x-ray does not reduce mortality from lung cancer in the general population or in ever-smokers.
- Harms
- False positive result
- The majority of 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.
Overdiagnosis
- Based on the current evidence, the majority of solitary pulmonary nodules detected by screening chest x-ray appear to represent overdiagnosed cancer.[8]
- The magnitude of overdiagnosis appears to be between 5% and 25%.
- These cancers result in unnecessary diagnostic procedures and also lead to unnecessary treatment.
- Harms of diagnostic procedures and treatment occur most frequently among long-term and/or heavy smokers because of smoking-associated comorbidities that increase risk propagation.
References
- ↑ Lung Cancer: Screening http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening. Accessed on February 3, 2016
- ↑ Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.
- ↑ National Lung Screening Trial. Wikipedia. https://en.wikipedia.org/wiki/National_Lung_Screening_Trial Accessed on February 4,2016
- ↑ Recommendations. US preventive services task force(2016) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=solitary_pulmonary_nodule Accessed on March, 15th 2016
- ↑ McWilliams A, Tammemagi MC, Mayo JR, et. al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med. 2013 Sep 5;369(10):910-9. doi:10.1056/NEJMoa1214726.
- ↑ Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB (2013). "Screening for Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 143 (5 Suppl): e78S–92S. doi:10.1378/chest.12-2350. PMID 23649455. Summary in JournalWatch
- ↑ Lung Cancer Screening. National Cancer Institute 2015. http://www.cancer.gov/types/lung/hp/lung-screening-pdq Accessed on December 20, 2015
- ↑ 8.0 8.1 Davis AM, Cifu AS. Lung Cancer Screening. JAMA. 2014;312(12):1248-1249. doi:10.1001/jama.2014.12272.