Lung cancer screening strategy for non-high-risk individuals: a narrative review

Fangqiu Fu; Yaodong Zhou; Yang Zhang; Haiquan Chen

doi:10.21037/tlcr-20-943

Lung cancer screening strategy for non-high-risk individuals: a narrative review

Transl Lung Cancer Res. 2021 Jan;10(1):452-461. doi: 10.21037/tlcr-20-943.

Authors

Fangqiu Fu^{1

2

3}, Yaodong Zhou^{1

2

3}, Yang Zhang^{1

2

3}, Haiquan Chen^{1

2

3}

Affiliations

¹ Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China.
² Institute of Thoracic Oncology, Fudan University, Shanghai, China.
³ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

Abstract

Lung cancer is the deadliest malignancy worldwide, accounting for almost 20% of all cancer deaths. Clinical trials, such as NLST and NELSON, have proved the survival benefit of lung cancer screening using low-dose computed tomography (LDCT), and most of the lung cancer screening guidelines recommended annual lung cancer screening by LDCT for high-risk individuals. However, a relatively high proportion of lung cancer patients do not have risk factors, and it is questionable whether non-high-risk individuals should receive LDCT screening. In this review, we reviewed risk factors of lung cancer and summarized the benefits and potential harms of LDCT screening. After clarifying the differences between China and western countries in lung cancer screening, we recommended that non-high-risk individuals should receive LDCT screening with an interval of five to ten years. To better balance benefits and harms from LDCT screening, we also proposed a flexible screening strategy using LDCT based on lung cancer risk. Hopefully, it may help reduce unnecessary radiation exposure from CT scans while decreasing mortality of lung cancer.

Keywords: Lung cancer screening; interval; low-dose computed tomography (LDCT); lung cancer risk.

Publication types

Review