Elsevier

Journal of Thoracic Oncology

Volume 8, Issue 10, October 2013, Pages 1232-1237
Journal of Thoracic Oncology

Original Articles
Screening High-Risk Populations for Lung Cancer: Guideline Recommendations

https://doi.org/10.1097/JTO.0b013e31829fd3d5Get rights and content
Under an Elsevier user license
open archive

Introduction

The aim of this practice guideline was to develop evidence-based recommendations for screening high-risk populations for lung cancer.

Methods

The guideline was developed using the methods of Cancer Care Ontario's Program in Evidence-Based Care. The core methodology of the Program in Evidence-Based Care's guideline development process is systematic review. A systematic review had recently been completed by a collaboration of the American Cancer Society, the American College of Chest Physicians, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network. The evidence from that systematic review formed the basis of the recommendations, which were reviewed, and amended where necessary, by clinical experts in the fields of medical and radiation oncology, radiology, lung disease, and population health.

Results

The systematic review included eight randomized controlled trials and 13 single-arm studies evaluating screening with low-dose computed tomography (LDCT) in patients at risk for lung cancer. One large randomized trial reported a statistically significant reduction in lung cancer mortality with LDCT at 6 years compared with chest radiography. The practice guideline recommendations generally align with the parameters of the National Lung Screening Study. Deviations were described and justified by the guideline working group. The recommendations support screening persons at high-risk for lung cancer with advice for determining a positive result on LDCT, appropriate follow-up, and optimal screening interval.

Conclusion

The benefits of screening high-risk populations for lung cancer with LDCT outweigh the harms if screening is implemented in a strictly controlled manner.

Key Words

Lung cancer
Screening
Low-dose computed tomography

Cited by (0)

Disclosure: Funding was provided from the Ontario Ministry of Health and Long-Term Care. The authors declare no other conflict of interest.