Health Technology Assessment in Action (Dec 2021)
Safety and Effectiveness of Lung Cancer Screening Using Low-Dose Computed Tomography Scan in High-Risk Individuals: A comprehensive review
Abstract
Introduction and Aim: Lung cancer is recognized as one of the most prevalent cancers and the most important cause of cancer mortality worldwide. Given the incidence and mortality of this disease, implementing preventive interventions is necessary. In this regard, the present study has investigated the effectiveness of one of the most important interventions of lung cancer screening (using low-dose computed tomography (CT) scan (LDCT)) in high-risk individuals. Method: The present study is an applied study performed as a comprehensive review. To assess safety, studies on the technical specifications of CT scans and issues related to the safety of applying this device for lung cancer screening were searched and surveyed using keywords in medical databases such as PubMed, Google Scholar, etc. To evaluate the clinical effectiveness, a comprehensive review of all studies regarding health technology assessment, systematic review and meta-analysis studies, and screening guidelines around the world was performed in this regard. Results: After searching and reviewing the safety issue, 1982 articles were extracted and finally the results of 15 studies were used. The diagnosis of harmless tumors, false positives and performing invasive complementary interventions for them, and the possible negative effects of radiation exposure are safety discussable issues. To measure clinical effectiveness, a total of 17827 studies were found through the surveyed medical databases, and finally 16 studies entered into the final phase of analysis. Based on the synthesis of studies, the effectiveness of lung cancer screening intervention using LDCT has been found to reduce lung cancer mortality by 15% to 20% and mortality from other causes by 0% to 6%. Also, as a result of this screening, the incidence of lung cancer and its diagnosis in the early stages of the disease increase and the incidence of this disease in its upper stages decreases significantly. The findings of the clinical effectiveness survey show that performing this intervention does not create any psychological consequences in individuals’ quality of life. Conclusion: Lung cancer screening using LDCT in older people with a high smoking history is safer than not performing the intervention, and does not threat the health of individuals undergoing screening. The disadvantages of this screening are negligible compared to its advantages. Compared to non-intervention, this screening is more clinically effective and will lead to a statistically significant reduction in lung cancer mortality and the increase of timely diagnosis of this disease.
