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(Chest. 2003;123:83S-88S.)
© 2003 American College of Chest Physicians

Screening for Lung Cancer*

The Guidelines

Peter B. Bach, MD, MAPP; Dennis E. Niewoehner, MD, FCCP and William C. Black, MD

* From the Health Outcomes Research Group (Dr. Bach), Department of Epidemiology and Biostatistics, and the Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY; the Pulmonary Section (Dr. Niewoehner), Veterans Affairs Medical Center, Minneapolis, MN; and the Department of Radiology (Dr. Black), Dartmouth-Hitchcock Medical Center, Lebanon, and the Department of Community and Family Medicine, Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH.

Correspondence to: Peter B. Bach, MD, MAPP, Health Outcomes Research Group, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 221, New York, NY 10021; e-mail: bachp{at}mskcc.org

Although virtually all individuals with advanced lung cancer succumb to the disease, a substantial portion of individuals diagnosed at an earlier stage can be cured. This dichotomy has provoked interest in lung cancer screening. To date, randomized controlled trials of chest x-ray and sputum cytology have failed to demonstrate that screening with either modality decreases lung cancer mortality; neither of these technologies can be recommended. Early studies of lung cancer screening with low-dose CT (LDCT) appear promising; however, only data from observational studies are available. We recommend that individuals should only be screened with LDCT in the context of well-designed clinical trials.

Key Words: evidence-based medicine • lung neoplasms • mass chest x-ray • mass screening • practice guideline • sputum • tomography, x-ray computed




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