The Future of Lung Cancer Screening: Current Challenges and Research Priorities

Abstract

Amna Burzic,1 Emma L O’Dowd,1,2 David R Baldwin1,2 1Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK; 2Division of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKCorrespondence: David R Baldwin, Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, NG5 1PB, UK, Tel [phone], Fax [phone], Email [email protected]: Lung cancer is the leading cause of cancer-related deaths worldwide, primarily because most people present when the stage is too advanced to offer any reasonable chance of cure. Over the last two decades, evidence has accumulated to show that early detection of lung cancer, using low-radiation dose computed tomography, in people at higher risk of the condition reduces their mortality. Many countries are now making progress with implementing programmes, although some have concerns about cost-effectiveness. Lung cancer screening is complex, and many factors influence clinical and cost-effectiveness. It is important to develop strategies to optimise each element of the intervention from selection and participation through optimal scanning, management of findings and treatment. The overall aim is to maximise benefits and minimise harms. Additional integrated interventions must include at least smoking cessation. In this review, we summarize the evidence that has accumulated to guide optimisation of lung cancer screening, discuss the remaining open questions about the best approach and identify potential barriers to successful implementation.Keywords: lung cancer, screening, computed tomography

Keywords

• lung cancer. screening. computed tomography.