Skip to main content
SpringerLink
Log in

Lung cancer screening

  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

The result of a lung cancer screening program should be fewer lung cancer-specific deaths in the screened population. studies evaluating chest imaging as a screening tool for lung cancer have not shown a reduction in lung cancer-specific mortality to date. The ability of institutions using chest imaging to meet the criteria for successful screening programs has also been debated. Contentious issues include the presence of an overdiagnosis bias, the ability to find preclinical disease at a curable point in time, the amount of pseudodisease identified, and the cost-effectiveness of screening programs. Current guidelines remain vague as randomized trials are being completed and technologic advances are occurring. The ultimate face of a successful lung cancer screening program is yet to be defined.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Obuchowski N, Modic MT: Whole-body CT screening for cancer and coronary disease: Does it pass the test? Cleve Clin J Med 2004, 71:47–56.

    PubMed  Google Scholar 

  2. McClure CD, Boucot KR, Shipman GA, et al.: The solitary pulm onary nodule and primary lung malignancy. Arch Environ Health 1961, 3:127–129.

    Google Scholar 

  3. Holin SM, Dwork RE, Glaser S, et al.: Solitary pulmonary nodules found in a community-wide chest roentgenographic survey: A 5-year follow-up study. Amer Rev Tuberc 1959, 79:427–439.

    CAS  Google Scholar 

  4. Weiss W, Boucot KR: The Philadelphia pulmonary neoplasm research project: Early roentgenographic appearance of bronchogenic carcinoma. Arch Intern Med 1974, 134:306–311.

    Article  PubMed  CAS  Google Scholar 

  5. Hayata Y, Funatsu H, Kato H, et al.: Results of lung cancer screening programs in Japan. Recent Results Cancer Res 1982, 82:163–173.

    PubMed  CAS  Google Scholar 

  6. An evaluation of radiologic and cytologic screening for the early detection of lung cancer: a cooperative pilot study of the American Cancer Society and the Veterans Administration. Cancer Res 1966, 26:2083–2121.

  7. Nash FA, Morgan JM, Tomkins JG: South London lung cancer study. Br Med J 1968, 2:715–721.

    PubMed  CAS  Google Scholar 

  8. Brett GZ: The value of lung cancer detection by six-monthly chest radiographs. Thorax 1968, 23:414–420.

    PubMed  CAS  Google Scholar 

  9. Wilde J: A 10 year follow-up of semi-annual screening for early detection of lung cancer in the Erfurt County, GDR. Eur Respir J 1989, 2:656–662.

    PubMed  CAS  Google Scholar 

  10. Friedman GD, Collen MF, Fireman BH: Multiphasic health checkup evaluation: a 16-year follow-up. J Chronic Dis 1986, 39:453–463.

    Article  PubMed  CAS  Google Scholar 

  11. Melamed MR, Flehinger BJ, Zaman MB, et al.: Screening for early lung cancer. Results of the Memorial Sloan-Kettering study in New York. Chest 1984, 86:44–53.

    PubMed  CAS  Google Scholar 

  12. Frost JK, Ball WC Jr, Levin ML, et al.: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. Am Rev Respir Dis 1984, 130:549–554.

    PubMed  CAS  Google Scholar 

  13. Marcus PM, Bergstralh EJ, Fagerstrom RM, et al.: Lung cancer mortality in the Mayo Lung Project: impact of extended follow-up. J Natl Cancer Inst 2000, 92:1308–1316.

    Article  PubMed  CAS  Google Scholar 

  14. Kubik A, Polak J: Lung cancer detection. Results of a randomized prospective study in Czechoslovakia. Cancer 1986, 57:2427–2437.

    Article  PubMed  CAS  Google Scholar 

  15. Eddy DM: Screening for lung cancer. Ann Intern Med 1989, 111:232–237.

    PubMed  CAS  Google Scholar 

  16. Okamoto N, Suzuki T, Hasegawa H, et al.: Evaluation of a clinic-based screening program for lung cancer with a case-control design in Kanagawa, Japan. Lung Cancer 1999, 25:77–85.

    Article  PubMed  CAS  Google Scholar 

  17. Sobue T: A case-control study for evaluating lung cancer screening in Japan. Cancer 2000, 89:2392–2396.

    Article  PubMed  CAS  Google Scholar 

  18. Sagawa M, Tsubono Y, Saito Y, et al.: A case-control study for evaluating the efficacy of mass screening program for lung cancer in Miyagi Prefecture, Japan. Cancer 2001, 92:588–594.

    Article  PubMed  CAS  Google Scholar 

  19. Tsukada H, Kurita Y, Yokoyama A, et al.: An evaluation of screening for lung cancer in Niigata Prefecture, Japan: a population-based case-control study. Br J Cancer 2001, 85:1326–1331.

    Article  PubMed  CAS  Google Scholar 

  20. Nishii K, Ueoka H, Kiura K, et al.: A case-control study of lung cancer in Okayama Prefecture, Japan. Lung Cancer 2001, 34:325–332.

    Article  PubMed  CAS  Google Scholar 

  21. Manser RL, Irving LB, Byrnes G, et al.: Screening for lung cancer: a systematic review and meta-analysis of controlled trials. Thorax 2003, 58:784–789.

    Article  PubMed  CAS  Google Scholar 

  22. Kaneko M, Eguchi K, Ohmatsu H, et al.: Peripheral lung cancer: Screening and detection with low-dosespiral CT versus radiography. Radiology 1996, 201:798–802.

    PubMed  CAS  Google Scholar 

  23. Sone S, Takashima S, Li F, et al.: Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet 1998, 351:1242–1245.

    Article  PubMed  CAS  Google Scholar 

  24. Henschke CI, McCauley DI, Yankelevitz DF, et al.: Early lung cancer action project: Overall design and findings from baseline screening. Lancet 1999, 354:99–105.

    Article  PubMed  CAS  Google Scholar 

  25. Henschke CI, Naidich DP, Yankelevitz DF, et al.: Early lung cancer action project. Initial findings on repeat screening. Cancer 2001, 92:153–159.

    Article  PubMed  CAS  Google Scholar 

  26. Sone S, Li F, Yang Z-G, et al.: Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner. Br J Cancer 2001, 84:25–32.

    Article  PubMed  CAS  Google Scholar 

  27. Nawa T, Nakagawa T, Kusano S, et al.: Lung cancer screening using low-dose spiral CT. Results of baseline and 1-year follow-up studies. Chest 2002, 122:15–20.

    Article  PubMed  Google Scholar 

  28. Sobue T, Moriyama N, Kaneko M, et al.: Screening for lung cancer with low-dose helical computed tomography: Anti-lung cancer association project. J Clin Oncol 2002, 20:911–920.

    Article  PubMed  Google Scholar 

  29. Swensen SJ, Jett JR, Sloan JA, et al.: Screening for lung cancer with low-dose spiral computed tomography. Am J Respir Crit Care Med 2002, 165:508–513.

    PubMed  Google Scholar 

  30. Swensen SJ, Jett JR, Hartman TE, et al.: Lung cancer screening with CT: Mayo Clinic experience. Radiology 2003, 226:756–761.

    Article  PubMed  Google Scholar 

  31. Swensen SJ, Jett JR, Hartman TE, et al.: CT screening for lung cancer: Five-year prospective experience. Radiology 2005, 235:259–265.

    Article  PubMed  Google Scholar 

  32. Diederich S, Wormanns D, Semik M, et al.: Screening for early lung cancer with low-dose spiral CT: Prevalence in 817 asymptomatic smokers. Radiology 2002, 222:773–781.

    Article  PubMed  Google Scholar 

  33. Diederich S, Thomas M, Semik M, et al.: Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers. Eur Radiol 2004, 14:691–702.

    Article  PubMed  Google Scholar 

  34. Pastorino U, Bellomi M, Landoni C, et al.: Early lungcancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results. Lancet 2003, 362:593–597.

    Article  PubMed  Google Scholar 

  35. Bastarrika G, Garcia-Velloso MJ, Lozano MD, et al.: Early lung cancer detection using spiral computed tomography and positron emission tomography. Am J Respir Crit Care Med 2005, 171:1378–1383.

    Article  PubMed  Google Scholar 

  36. MacRedmond R, Logan PM, Lee M, et al.: Screening for lung cancer using low dose CT scanning. Thorax 2004, 59:237–241.

    Article  PubMed  CAS  Google Scholar 

  37. Titola M, Kivisaari L, Huuskonen MS, et al.: Computed tomography screening for lung cancer in asbestos-exposed workers. Lung Cancer 2002, 35:17–22.

    Article  Google Scholar 

  38. Chong S, Lee KS, Chung MJ, et al.: Lung cancer screening with low-dose helical CT in Korea: experiences at the Samsung Medical Center. J Korean Med Sci 2005, 20:402–408.

    Article  PubMed  Google Scholar 

  39. Miller A, Markowitz S, Manowitz A, Miller JA: Lung cancer screening using low-dose high-resolution CT scanning in a high-risk workforce. 3,500 nuclear fuel workers in three US states. Chest 2004, 125:152S–153S.

    Article  PubMed  Google Scholar 

  40. The International Early Lung Cancer Action Program Investigators: Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006, 355:1763–1771.

    Article  Google Scholar 

  41. Fontana RS, Sanderson DR, Woolner LB, et al.: Screening for lung cancer. A critique of the Mayo Lung project. Cancer 1991, 67:1155–1164.

    Article  PubMed  CAS  Google Scholar 

  42. Patz EF, Swensen SJ, Herndon JE: Estim ate of lung cancer mortality from low-dose spiral computed tomography screening trials: Implications for current mass screening recom mendations. J Clin Oncol 2004, 22:2202–2206.

    Article  PubMed  Google Scholar 

  43. Gohagan JK, Marcus PM, Fagerstrom RM, et al.: Final results of the lung screening study, a randomized feasibility study of spiral CT versus chest x-ray screening for lung cancer. Lung Cancer 2005, 47:9–15.

    Article  PubMed  Google Scholar 

  44. Motohiro A, Ueda H, Komatsu H, et al.: Prognosis of non-surgically treated, clinical stage I lung cancer patients in Japan. Lung Cancer 2002, 36:65–69.

    Article  PubMed  Google Scholar 

  45. Bach PB, Jett JR, Pastorino U, et al.: Computed tomography screening and lung cancer outcomes. JAMA 2007, 297:953–961.

    Article  PubMed  CAS  Google Scholar 

  46. Sato M, Saito Y, Endo C, et al.: The natural history of radiographically occult bronchogenic squamous cell carcinoma. A retrospective study of overdiagnosis bias. Chest 2004, 126:108–113.

    Article  PubMed  Google Scholar 

  47. Bianchi F, Hu J, Pelosi G, et al.: Lung cancers detected by screening with spiral computed tomography have a malign ant phenotype when analyzed by cDNA microarray. Clin Cancer Res 2004, 10:6023–6028.

    Article  PubMed  CAS  Google Scholar 

  48. Read WL, Tierney RM, Page NC, et al.: Differential prognostic impact of comorbidity. J Clin Oncol 2004, 22:3099–3103.

    Article  PubMed  Google Scholar 

  49. Manser RL, Dodd M, Byrnes G, et al.: Incidental lung cancers identified at coronial autopsy: implications for over diagnosis of lung cancer by screening. Respir Med 2005, 99:501–507.

    Article  PubMed  Google Scholar 

  50. Jemal A, Siegel R, Ward E, et al.: Cancer statistics, 2006. CA Cancer J Clin 2007, 57:43–66.

    Article  PubMed  Google Scholar 

  51. Patz EF, Rossi S, Harpole DH, et al.: Correlation of tum or size and survival in patients with stage IA non-small cell lung cancer. Chest 2000, 117:1568–1571.

    Article  PubMed  Google Scholar 

  52. Heyneman LE, Herndon JE, Goodman PC, Patz EF: Stage distribution in patients with a small (≤ 3 cm) primary nonsmall cell carcinoma. Implication for lung carcinom a screening. Cancer 2001, 92:3051–3055.

    Article  PubMed  CAS  Google Scholar 

  53. Lopez-Encuentra A, Duque-Medina JL, Rami-Porta R, et al.: Staging in lung cancer: Is 3 cm a prognostic threshold in pathologic stage I non-small cell lung cancer? A multicenter study of 1,020 patients. Chest 2002, 121:1515–1520.

    Article  PubMed  Google Scholar 

  54. Wisnivesky JP, Yankelevitz D, Henschke CI: The effect of tum or size on curability of stage I non-small cell lung cancers. Chest 2004, 126:761–765.

    Article  PubMed  Google Scholar 

  55. Wisnivesky JP, Yankelvitz D, Henschke CI: Stage of lung cancer in relation to its size. Part 2. Evidence. Chest 2005, 127:1136–1139.

    Article  PubMed  Google Scholar 

  56. Mery CM, Pappas AN, Burt BM, et al.: Diameter of non-small cell lung cancer correlates with long-term survival. Implications for T stage. Chest 2005, 128:3255–3260.

    Article  PubMed  Google Scholar 

  57. Lindell RM, Hartman TE, Swensen SJ, et al.: Lung cancer screening experience: A retrospective review of PET in 22 non-small cell lung carcinom as detected on screening chest CT in a high-risk population. AJR Am J Roentgenol 2005, 185:126–131.

    PubMed  Google Scholar 

  58. Fischbach F, Knollmann F, Griesshaber, et al.: Detection of pulmonary nodules by multislice computed tomography: improved detection rate with reduced slice thickness. Eur Radiol 2003, 13:2378–2383.

    Article  PubMed  Google Scholar 

  59. Townsend CO, Clark MM, Jett JR, et al.: Relation between smoking cessation and receiving results from three annual spiral chest computed tomography scans for lung carcinom a screening. Cancer 2005, 103:2154–2162.

    Article  PubMed  Google Scholar 

  60. Buls N, de Mey J, Covens P, Stadnik T: Health screening with CT: prospective assessment of radiation dose and associated detriment. JBR-BTR 2005, 88:12–16.

    PubMed  CAS  Google Scholar 

  61. Brenner DJ: Radiation risks potentially associated with low-dose CT screening of adult smokers for lung cancer. Radiology 2004, 231:440–445.

    Article  PubMed  Google Scholar 

  62. Chirikos TN, Hazelton T, Tockman M, Clark R: Screening for lung cancer with CT. A preliminary cost-effectiveness analysis. Chest 2002, 121:1507–1514.

    Article  PubMed  Google Scholar 

  63. Mahadevia PJ, Fleisher LA, Frick KD, et al.: Lung cancer screening with helical computed tomography in older adult smokers. A decision and cost-effectiveness analysis. JAMA 2003, 289:313–322.

    Article  PubMed  Google Scholar 

  64. Wisnivesky JP, Mushlin AI, Sicherman N, Henschke C: The cost-effectiveness of low-dose CT screening for lung cancer. Preliminary results of baseline screening. Chest 2003, 124:614–621.

    Article  PubMed  Google Scholar 

  65. Manser R, Dalton A, Carter R, et al.: Cost-effectiveness analysis of screening for lung cancer with low dose spiral CT (computed tomography) in the Australian setting. Lung Cancer 2005, 48:171–185.

    Article  PubMed  Google Scholar 

  66. Henschke CI, Yankelevitz DF, Naidich DP, et al.: CT screening for lung cancer: suspiciousness of nodules according to size on baseline scans. Radiology 2004, 231:164–168.

    Article  PubMed  Google Scholar 

  67. Bach PB, Kattan MW, Thornquist MD, et al.: Variations in lung cancer risk among smokers. J Natl Cancer Inst 2003, 95:470–478.

    Article  PubMed  Google Scholar 

  68. Bach PB, Elkin EB, Pastorino U, et al.: Benchmarking lung cancer mortality rates in current and former smokers. Chest 2004, 126:1742–1749.

    Article  PubMed  Google Scholar 

  69. Bechtel JJ, Kelley WA, Coons TA, et al.: Lung cancer detection in patients with airflow obstruction identified in a primary care outpatient practice. Chest 2005, 127:1140–1145.

    Article  PubMed  Google Scholar 

  70. Smith RA, von Eschenbach AC, Wender R, et al.: American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: Update 2001 — testing for early lung cancer detection. CA Cancer J Clin 2001, 51:38–75.

    PubMed  CAS  Google Scholar 

  71. US Preventive Service Task Force: Lung cancer screening: Recommendation statement. Ann Intern Med 2004, 140:738–739.

    Google Scholar 

  72. Aberle DR, Gamsu G, Henschke CI, et al.: A consensus statement of the Society of Thoracic Radiology: screening for lung cancer with helical computed tomography. J Thorac Imaging 2001, 16:65–68.

    Article  PubMed  CAS  Google Scholar 

  73. Bach PB, Niewoehner DE, Black WC: Screening for lung cancer. The guidelines. Chest 2003, 123:825–885.

    Article  Google Scholar 

  74. Strauss GM, Dominioni L, Jett JR, et al.: Como International Conference position statement. Lung cancer screening for early diagnosis 5 years after the 1998 Varese conference. Chest 2005, 127:1146–1151.

    Article  PubMed  Google Scholar 

  75. Gohagan J, Marcus P, Fagerstrom R, et al.: Baseline findings of a randomized feasibility trial of lung cancer screening with spiral CT scan vs. chest radiograph: The Lung Screening Study of the National Cancer Institute. Chest 2004, 126:114–121.

    Article  PubMed  Google Scholar 

  76. Yanagisawa K, Shyr Y, Xu BJ, et al.: Proteomic patterns of tum or subsets in non-small-cell lung cancer. Lancet 2003, 362:433–439.

    Article  PubMed  CAS  Google Scholar 

  77. Zhong L, Hidalgo GE, Stromberg AJ, et al.: Using protein microarray as a diagnostic assay for non-small cell lung cancer. Am J Respir Crit Care Med 2005, 172:1308–1314.

    Article  PubMed  Google Scholar 

  78. Phillips M, Cataneo RN, Cummin ARC, et al.: Detection of lung cancer with volatile markers in the breath. Chest 2003, 123:2115–2123.

    Article  PubMed  CAS  Google Scholar 

  79. Machado RF, Laskowski D, Deffenderfer O, et al.: Detection of lung cancer by sens or array analysis of exhaled breath. Am J Respir Crit Care Med 2005, 171:1–6.

    Article  Google Scholar 

  80. Mazzone PJ, Hammel J, Dweik RA, et al.: Lung cancer diagnosis by the analysis of exhaled breath with a colorimetric sensor array. Thorax 2007 [Epub ahead of print].

Download references

Author information

Authors and Affiliations

  1. Department of Pulmonary, Allergy, and Critical Care Medicine, The Cleveland Clinic Foundation, 9500 Euclid Avenue, A90, Cleveland, OH, 44195, USA

    Peter J. Mazzone MD, MPH, FRCPC, FCCP

Authors
  1. Peter J. Mazzone MD, MPH, FRCPC, FCCP
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tarek Mekhail MD, MSc, FRCSI, FRCSEd
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter J. Mazzone MD, MPH, FRCPC, FCCP.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mazzone, P.J., Mekhail, T. Lung cancer screening. Curr Oncol Rep 9, 265–274 (2007). https://doi.org/10.1007/s11912-007-0032-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11912-007-0032-1

Keywords

Search

Navigation