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Screening for lung cancer with spiral CT is not justified

Nature Clinical Practice Oncology volume 4, pages 442–443 (2007)Cite this article

There is little doubt that the successful resection of a clinically detected lung carcinoma results in cure in some patients, in contradistinction to those patients with inoperable lung cancer, who have a very poor survival. As such, it is reasonable to presuppose that those patients presenting with inoperable lung cancer might have had operable disease if diagnosed earlier. From this assumption, it follows that if patients at increased risk for lung cancer (and this category would need to be carefully defined) were screened by a test that detected these cancers at an early operable stage then their lives would be saved and mortality from lung cancer would fall. Unfortunately, life and lung cancer are not that simple.

Ideally, a patient with lung cancer would undergo an initial screening CT scan, their small malignant pulmonary nodule would be detected, a second noninvasive test would be performed to confirm nodule malignancy, and they would then undergo a thoracotomy (probably a lobectomy) and be cured. In the ideal scenario, all of these procedures would be performed in a cost-effective manner. Unfortunately, there are a considerable number of hurdles associated with this pathway that make the process more complex. Screening for lung cancer might lack value because of these difficulties.

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  1. Churchill Hospital, Oxford Radcliffe Hospitals, Old Road, Headington, Oxford OX3 7LJ, UK fergus.gleeson@nds.ox.ac.uk

Authors and Affiliations

  1. FV Gleeson is a Consultant Radiologist and the Director of the Radiology Department at the Churchill Hospital, Oxford, UK.,

    Fergus V Gleeson

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  1. Fergus V Gleeson
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Gleeson, F. Screening for lung cancer with spiral CT is not justified. Nat Rev Clin Oncol 4, 442–443 (2007). https://doi.org/10.1038/ncponc0878

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