Lung cancer screening in 2022: a narrative review

Patrick Bradley, Marcus Taylor, Sara Ugolini, Philip A.J. Crosbie, Felice Granato, Haval Balata, Richard Booton

Research output: Contribution to journalReview articlepeer-review

Abstract

Background and Objective: In recent years, strong evi dence has emerged supporti ng the implementation of lung cancer screening. The impact of the widespread introduction of screening on lung cancer services, including the anticipated increase in thoracic surgical activity, must be considered. This review explores the evidence underpinning lung cancer screening, identifies challenges, and outlines potential strategies to facilitate the successful implementation of such programs. Methods: A literature search on aspects of lung cancer screening was performed using PubMed from inception to May 2022. Topics included low dose CT lung cancer screening, harms of screening, targeted screening methods, service delivery, and surgical management of early stage lung cancer. Emphasis was placed on randomised controlled trials (RCTs) and clinical guidelines. Key Content and Findings: Targeted screening offers a 20–24% lung cancer mortality reduction by diagnosing disease at earlier stages, when the gold standard treatment of surgical resection is possible. Screening brings risks of harm, such as overdiagnosis of indolent disease and healthcare resource use. Pilot screening programmes offer lessons to mitigate these harms in practice, and healthcare systems are increasingly interested in implementing national screening programmes as technological advances improve safety and cost-effectiveness. Prospective research into participant selection, nodule management, and treatment strategies are ongoing. Conclusions: An increasing caseload of curable lung cancer compels leverage of surgical and non-surgical treatments for lung cancer and related comorbidity to further enhance the effectiveness of screening.

Original languageEnglish
Article number14
JournalVideo-Assisted Thoracic Surgery
Volume7
DOIs
Publication statusPublished - Sept 2022

Keywords

  • early detection
  • Lung cancer
  • Lung Health Checks (LHC)
  • screening
  • thoracic surgery

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