Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition) Journal Article

  

Authors:	Bach, P. B.; Silvestri, G. A.; Hanger, M.; Jett, J. R.
Article Title:	Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition)
Abstract:	Background: Lung cancer typically exhibits symptoms only after the disease has spread, making cure unlikely. Because early-stage disease can be successfully treated, a screening technique that can detect lung cancer before it has spread might be useful in decreasing lung cancer mortality. Objectives: In this article, we review the evidence for and against screening for lung cancer with low-dose CT and offer recommendations regarding its usefulness for asymptomatic patients with no history of cancer. Results: Studies of lung cancer screening with chest radiograph and sputum cytology have failed to demonstrate that screening lowers lung cancer mortality rates. Published studies of newer screening technologies such as low-dose CT and "biomarker" screening report primarily on lung cancer detection rates and do not present sufficient data to determine whether the newer technologies will benefit or harm. Although researchers are conducting randomized trials of low-dose CT, results will not be available for several years. In the meantime, cost-effectiveness analyses and studies of nodule growth are considering practical questions but producing inconsistent findings. Conclusions: For high-risk populations, no screening modality has been shown to alter mortality outcomes. We recommend that individuals undergo screening only when it is administered as a component of a well-designed clinical trial with appropriate human subjects' protections.
Keywords:	review; cancer staging; methodology; neoplasm staging; evidence based medicine; evidence-based medicine; cytology; computer assisted tomography; randomized controlled trial; lung neoplasms; cancer screening; lung cancer; mass screening; tomography, x-ray computed; practice guideline; pathology; cancer mortality; economics; lung tumor; randomized controlled trials; radiography; thorax radiography; high risk population; low energy radiation; cost-benefit analysis; cost benefit analysis; sputum cytodiagnosis; chest radiograph; lung cancer screening; sputum cytology; sputum; biomolecular markers; low-dose ct
Journal Title:	Chest
Volume:	132
Issue:	3 Suppl.
ISSN:	0012-3692
Publisher:	American College of Chest Physicians
Date Published:	2007-09-01
Start Page:	69S
End Page:	77S
Language:	English
DOI:	10.1378/chest.07-1349
PUBMED:	17873161
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-34848866957&partnerID=40&md5=9eeebec9bffaaf217b68aac910484fe2
Notes:	--- - "Cited By (since 1996): 54" - "Export Date: 17 November 2011" - "CODEN: CHETB" - "Source: Scopus"

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