Summary of Evidence
Separate PDQ summaries on Lung Cancer Prevention, Small Cell Lung Cancer Treatment, Non-Small Cell Lung Cancer Treatment, and Levels of Evidence for Cancer Screening and Prevention Studies are also available.
Screening for Lung Cancer With Chest X-Ray and/or Sputum Cytology
Although lung cancer is the leading cause of cancer death in the U.S. in both men and women, both the occurrence of lung cancer and the deaths related to it can be reduced. More than four out of every five cases of lung cancer are associated with cigarette smoking. The cause-and-effect relationship has been extensively documented. During the 1920s, large numbers of men began to smoke cigarettes, presumably in response to increased advertising. Twenty years later, the frequency of lung cancer in men...
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Benefits
Based on fair evidence, screening does not reduce mortality from lung cancer.
Description of the Evidence
- Study Design: Evidence obtained from randomized controlled trials.
- Internal Validity: Fair, due to lack of unscreened groups and contamination.
- Consistency: Good.
- Direction and Magnitude of Effect: No evidence of effect.
- External Validity: Fair, due to lack of women and minority groups.
Harms
Based on solid evidence, screening would lead to false-positive tests and unnecessary invasive diagnostic procedures and treatments.
Description of the Evidence
- Study Design: Evidence obtained from randomized controlled trials.
- Internal Validity: Fair.
- Consistency: Good.
- Direction and Magnitude of Effect: False-positive results range from 4% to 15%; there is a possibility of overdiagnosis and overtreatment (magnitude uncertain).
- External Validity: Fair.
Screening for Lung Cancer With Low-Dose Helical Computed Tomography (LDCT)
Benefits
The evidence is inadequate to determine whether screening reduces mortality from lung cancer.
Description of the Evidence
- Study Design: Evidence obtained from cohort or case-control studies.
- Internal Validity: Poor for answering the question of mortality reduction from screening with LDCT.
- Consistency: Good.
- Direction and Magnitude of Effect: Cannot determine from the available studies.
- External Validity: Not applicable; the internal validity of the evidence is poor.
Harms
Based on solid evidence, screening would lead to false-positive tests and unnecessary invasive diagnostic procedures and treatments.
Description of the Evidence
- Study Design: Evidence obtained from cohort or case-control studies.
- Internal Validity: Poor.
- Consistency: Good.
- Direction and Magnitude of Effect: False-positive results range from 20% to 50%; overdiagnosis and overtreatment are possible (magnitude uncertain).
- External Validity: Fair.
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