RT Journal Article
SR Electronic
T1 Guidelines for the use of spiral computed tomography in screening for lung cancer
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 45s
OP 51s
DO 10.1183/09031936.03.00405103
VO 21
IS 39 suppl
A1 C.I. Henschke
A1 D.F. Yankelevitz
A1 D.I. McCauley
A1 D.M. Libby
A1 M.W. Pasmantier
A1 J.P. Smith
YR 2003
UL http://erj.ersjournals.com/content/21/39_suppl/45s.abstract
AB 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.