TY - JOUR T1 - Guidelines for the use of spiral computed tomography in screening for lung cancer JF - European Respiratory Journal JO - Eur Respir J SP - 45s LP - 51s DO - 10.1183/09031936.03.00405103 VL - 21 IS - 39 suppl AU - C.I. Henschke AU - D.F. Yankelevitz AU - D.I. McCauley AU - D.M. Libby AU - M.W. Pasmantier AU - J.P. Smith Y1 - 2003/01/01 UR - http://erj.ersjournals.com/content/21/39_suppl/45s.abstract N2 - Screening should be considered in lung cancer, more than any other cancer. Not only is the disease highly fatal, essentially incurable, when diagnosed on the prompting of symptoms and/or clinical signs, but its occurrence is also highly concentrated in identifiably high-risk persons. The degree of usefulness of computed tomography (CT)-based screening for lung cancer must be thought of in reference to a particular, presumably optimal, regimen of pursuing early stage diagnosis. This is an algorithm that begins with the initial test (“screening CT”) and ends in either discontinuation of the diagnostic pursuit or in diagnosis of lung cancer. A carefully developed, extensively pilot tested and critically reviewed, updated protocol for CT-based screening for lung cancer is presented here. Its implementation is addressed, together with quality assurance. Finally, the associated curability rate for lung cancer is addressed in the light of what is known or can be surmised from evidence already available. However, recommendation for or against screening requires further information. Principally, the patients risk for lung cancer (in the near future) and the patients life expectancy (when spared of death from lung cancer). These two factors influence when, if ever, to begin screening, and if it is initiated, when to discontinue it. Finally, cost-effectiveness of the screening program should also be considered. ER -