Systematic review supports low-dose computed tomography for patients at risk for lung cancer


The American Cancer Society (ACS) has sanctioned new guidelines regarding the efficacy and efficiency of low-dose computed tomography (CT) screening for patients at high risk for lung cancer.

Such testing is permissible and encouraged when the following conditions are confirmed:

Figure 1:

 

Information and data from the American Cancer Society. Presentation by PhysBizTech.

Since the results of the National Lung Cancer Screening Trial (NLST) came back in 2010, the ACS and other key organizations that deal with smoking and the conditions that arise because of it, have been tapping their way into the CT ashtray, so to speak. The ACS combined forces with the American College of Chest Physicians, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network to produce a series of systematic evidence reviews and investigations regarding the effects of CT scanning on at-risk patient demographics. 

The review focused on four main questions:

  • What are the potential benefits of screening individuals at high risk of developing lung cancer using LDCT?
  • What are the potential harms of screening individuals at high risk of developing lung cancer using LDCT?
  • Which groups are likely to benefit or not benefit?
  • In what setting is screening likely to be effective?

"Findings from the National Cancer Institute's National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives," wrote the review's authors.

“At this time, there is sufficient evidence to support screening provided that the patient has undergone a thorough discussion of the benefits, limitations and risks, and can be screened in a setting with experience in lung cancer screening," they concluded.

Despite there being enough evidence to make certain allowances, the authors also highlighted a need for continued surveillance of the method. Furthermore, they stated, "As with other guidelines for cancer screening, we can expect that this initial guideline will be revised as new data become available."

The goal of the new parameters? Adults with high-risk habits for the disease will be encouraged to make more informed decisions following an early screening and analysis. Nevertheless, early CT scanning does proffer its own distinct set of difficulties alongside its pending ability to bring down lung cancer mortality rates.  

"Whether community based screening for lung cancer with LDCT will exceed or fail to achieve the benefit observed in the NLST could be influenced by many factors, and the answer awaits the results of further observation and research," the authors cautioned.

The review and guidelines are being published early in CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the ACS.