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Lung Cancer Screening (PDQ®) - 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

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, as 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.

WebMD Public Information from the National Cancer Institute

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Last Updated: January 18, 2008

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