Screening Or Not Screening For Lung Cancer: Consider The Benefit

Main Category: Lung Cancer
Also Included In: Cancer / Oncology;  Respiratory / Asthma
Article Date: 26 Oct 2007 - 11:00 PDT

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Individuals contemplating computed tomographic (CT) screening for lung cancer because they are concerned that they are at risk should talk to their physicians. In this discussion, information on the benefit of the screening for that particular person, based on their age and smoking history, needs to be available to the person and the consulting physician.

An article by Claudia Henschke (New York Presbyterian Hospital - Weill Cornell Medical Center, USA) and her colleagues of the International Early Lung Cancer Action Program provides an estimate of the benefit of the first, baseline round of screening.
This benefit depends on the probability that the screening of that person will result in the diagnosis of lung cancer, the probability of cure resulting from early treatment of lung cancer detected by screening and on the probability that the person will not die from some other cause in the next 10 years and thus enjoy the benefit of the early detection.

The probability of benefit ranges from 0.4% for a 60-year old with a smoking history of 10 pack-years who quit 20 years ago, to 3.1% for a 70-year-old current smoker with 100 pack-years smoking, and 2.0% for a 85-year-old current smoker with 150 pack-years smoking. In the absence of screening the benefit is essentially 0%. The question that the particular person then needs to answer is whether the benefit is worth the cost of the CT scan (around US$300), much like buying insurance for a future adverse event that has a certain probability of occurring.

European Respiratory Journal