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Summary of Evidence
Screening for Lung Cancer with Chest X-Ray and/or Sputum Cytology
Benefits
Harms
Screening for Lung Cancer with Low-Dose Helical Computed Tomography (LDCT)
Benefits
Harms
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
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Study Design: Evidence obtained from randomized controlled trials.
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Internal Validity: Fair, due to lack of unscreened groups and contamination.
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Consistency: Good.
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Direction and Magnitude of Effect: No evidence of effect.
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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
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Study Design: Evidence obtained from randomized controlled trials.
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Internal Validity: Fair.
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Consistency: Good.
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Direction and Magnitude of Effect: False-positive results range from 4% to 15%; there is a possibility of overdiagnosis and overtreatment (magnitude uncertain).
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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
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Study Design: Evidence obtained from cohort or case-control studies.
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Internal Validity: Poor for answering the question of mortality reduction from screening with LDCT.
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Consistency: Good.
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Direction and Magnitude of Effect: Cannot determine from the available studies.
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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
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Study Design: Evidence obtained from cohort or case-control studies.
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Internal Validity: Poor.
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Consistency: Good.
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Direction and Magnitude of Effect: False-positive results range from 20% to 50%; overdiagnosis and overtreatment are possible (magnitude uncertain).
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External Validity: Fair.
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