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Lung Cancer Screening
Christopher M. Walker, MD
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KEY FACTS

  • BACKGROUND

    • CRITERIA FOR SCREENING

      • DIFFERENTIAL DIAGNOSIS

        • CLINICAL ISSUES

          • REPORTING RECOMMENDATIONS

            BACKGROUND

            • Lung Cancer

              • Initial Screening Trials

                • Low-Dose Chest CT (LDCT) Screening

                  • National Lung Screening Trial (NLST)

                    • NELSON Trial

                      COMPONENTS OF SCREENING PROGRAM

                      • LDCT

                        • Additional Requirements

                          CRITERIA FOR SCREENING

                          • Asymptomatic, High-Risk Individuals

                            IMAGING FINDINGS

                            • Reporting

                              DIFFERENTIAL DIAGNOSIS

                              • Intrapulmonary Lymph Node

                                • Noncalcified Granuloma

                                  • Lung Cancer

                                    • Hamartoma

                                      • Carcinoid

                                        PATHOLOGY

                                        • NSCLC

                                          • Small Cell Carcinoma

                                            CLINICAL ISSUES

                                            • Potential Benefits

                                              • Potential Harms

                                                • Risk Prediction Models

                                                  • Prevention

                                                    REPORTING RECOMMENDATIONS

                                                    • Lung-RADS

                                                      IMAGING FOLLOW-UP

                                                      • Lung-RADS

                                                        Selected References

                                                        1. American College of Radiology: Lung-RADS. Accessed June 1, 2015.
                                                        2. Carter BW et al: Lung Cancer Screening: How to Do it. Semin Roentgenol. 50(2):82-7, 2015
                                                        3. de Groot PM et al: Lung cancer screening-why do it? Tobacco, the history of screening, and future challenges. Semin Roentgenol. 50(2):72-81, 2015
                                                        4. Moyer VA et al: Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 160(5):330-8, 2014
                                                        5. National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, Gareen IF, Gatsonis C, Marcus PM, Sicks JD. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011 Aug 4;365(5):395-409. Epub 2011 Jun 29. PubMed PMID: 21714641
                                                        6. National Lung Screening Trial Research Team et al: The National Lung Screening Trial: overview and study design. Radiology. 258(1):243-53, 2011
                                                        7. Oken MM et al: Screening by chest radiograph and lung cancer mortality: the Prostate, Lung, Colorectal, and Ovarian (PLCO) randomized trial. JAMA. 306(17):1865-73, 2011
                                                        8. International Early Lung Cancer Action Program Investigators et al: Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med. 2006 Oct 26;355(17):1763-71. Erratum in: N Engl J Med. 2008 Aug 21;359(8):877. N Engl J Med. 2008 Apr 24;358(17):1862. N Engl J Med. 358(17):1875, 2008
                                                        9. Diederich S et al: Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology. 222(3):773-81, 2002
                                                        10. Swensen SJ et al: Screening for lung cancer with low-dose spiral computed tomography. Am J Respir Crit Care Med. 165(4):508-13, 2002
                                                        11. Henschke CI et al: Early lung cancer action project: initial findings on repeat screenings. Cancer. 92(1):153-9, 2001
                                                        12. Sone S et al: Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner. Br J Cancer. 84(1):25-32, 2001
                                                        13. Kubík A et al: Lung cancer detection. Results of a randomized prospective study in Czechoslovakia. Cancer. 57(12):2427-37, 1986
                                                        14. Flehinger BJ et al: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Memorial Sloan-Kettering study. Am Rev Respir Dis. 130(4):555-60, 1984
                                                        15. Fontana RS et al: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Mayo Clinic study. Am Rev Respir Dis. 130(4):561-5, 1984
                                                        16. Frost JK et al: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. Am Rev Respir Dis. 130(4):549-54, 1984
                                                        Related Anatomy
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                                                        References
                                                        Tables

                                                        Tables

                                                        KEY FACTS

                                                        • BACKGROUND

                                                          • CRITERIA FOR SCREENING

                                                            • DIFFERENTIAL DIAGNOSIS

                                                              • CLINICAL ISSUES

                                                                • REPORTING RECOMMENDATIONS

                                                                  BACKGROUND

                                                                  • Lung Cancer

                                                                    • Initial Screening Trials

                                                                      • Low-Dose Chest CT (LDCT) Screening

                                                                        • National Lung Screening Trial (NLST)

                                                                          • NELSON Trial

                                                                            COMPONENTS OF SCREENING PROGRAM

                                                                            • LDCT

                                                                              • Additional Requirements

                                                                                CRITERIA FOR SCREENING

                                                                                • Asymptomatic, High-Risk Individuals

                                                                                  IMAGING FINDINGS

                                                                                  • Reporting

                                                                                    DIFFERENTIAL DIAGNOSIS

                                                                                    • Intrapulmonary Lymph Node

                                                                                      • Noncalcified Granuloma

                                                                                        • Lung Cancer

                                                                                          • Hamartoma

                                                                                            • Carcinoid

                                                                                              PATHOLOGY

                                                                                              • NSCLC

                                                                                                • Small Cell Carcinoma

                                                                                                  CLINICAL ISSUES

                                                                                                  • Potential Benefits

                                                                                                    • Potential Harms

                                                                                                      • Risk Prediction Models

                                                                                                        • Prevention

                                                                                                          REPORTING RECOMMENDATIONS

                                                                                                          • Lung-RADS

                                                                                                            IMAGING FOLLOW-UP

                                                                                                            • Lung-RADS

                                                                                                              Selected References

                                                                                                              1. American College of Radiology: Lung-RADS. Accessed June 1, 2015.
                                                                                                              2. Carter BW et al: Lung Cancer Screening: How to Do it. Semin Roentgenol. 50(2):82-7, 2015
                                                                                                              3. de Groot PM et al: Lung cancer screening-why do it? Tobacco, the history of screening, and future challenges. Semin Roentgenol. 50(2):72-81, 2015
                                                                                                              4. Moyer VA et al: Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 160(5):330-8, 2014
                                                                                                              5. National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, Gareen IF, Gatsonis C, Marcus PM, Sicks JD. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011 Aug 4;365(5):395-409. Epub 2011 Jun 29. PubMed PMID: 21714641
                                                                                                              6. National Lung Screening Trial Research Team et al: The National Lung Screening Trial: overview and study design. Radiology. 258(1):243-53, 2011
                                                                                                              7. Oken MM et al: Screening by chest radiograph and lung cancer mortality: the Prostate, Lung, Colorectal, and Ovarian (PLCO) randomized trial. JAMA. 306(17):1865-73, 2011
                                                                                                              8. International Early Lung Cancer Action Program Investigators et al: Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med. 2006 Oct 26;355(17):1763-71. Erratum in: N Engl J Med. 2008 Aug 21;359(8):877. N Engl J Med. 2008 Apr 24;358(17):1862. N Engl J Med. 358(17):1875, 2008
                                                                                                              9. Diederich S et al: Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology. 222(3):773-81, 2002
                                                                                                              10. Swensen SJ et al: Screening for lung cancer with low-dose spiral computed tomography. Am J Respir Crit Care Med. 165(4):508-13, 2002
                                                                                                              11. Henschke CI et al: Early lung cancer action project: initial findings on repeat screenings. Cancer. 92(1):153-9, 2001
                                                                                                              12. Sone S et al: Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner. Br J Cancer. 84(1):25-32, 2001
                                                                                                              13. Kubík A et al: Lung cancer detection. Results of a randomized prospective study in Czechoslovakia. Cancer. 57(12):2427-37, 1986
                                                                                                              14. Flehinger BJ et al: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Memorial Sloan-Kettering study. Am Rev Respir Dis. 130(4):555-60, 1984
                                                                                                              15. Fontana RS et al: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Mayo Clinic study. Am Rev Respir Dis. 130(4):561-5, 1984
                                                                                                              16. Frost JK et al: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. Am Rev Respir Dis. 130(4):549-54, 1984