TY - JOUR
T1 - Lung cancer screening in 2022
T2 - a narrative review
AU - Goodley, Patrick
AU - Taylor, Marcus
AU - Ugolini, Sara
AU - Crosbie, Philip A.J.
AU - Granato, Felice
AU - Balata, Haval
AU - Booton, Richard
N1 - Publisher Copyright:
© Video-Assisted Thoracic Surgery.
PY - 2022/9/30
Y1 - 2022/9/30
N2 - 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.
AB - 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.
KW - early detection
KW - Lung cancer
KW - Lung Health Checks (LHC)
KW - screening
KW - thoracic surgery
UR - http://www.scopus.com/inward/record.url?scp=85139525955&partnerID=8YFLogxK
U2 - 10.21037/vats-22-10
DO - 10.21037/vats-22-10
M3 - Review article
AN - SCOPUS:85139525955
VL - 7
JO - Video-Assisted Thoracic Surgery
JF - Video-Assisted Thoracic Surgery
M1 - 14
ER -