REVIEW ARTICLE

SCREENING FOR LUNG CANCER: TO DO OR NOT TO DO?

By
James R Jett
Pulmonary Medicine and Medical Oncology, Mayo Clinic, Rochester

Screening for cervical cancer, breast cancer and colon cancer have all been shown to decrease deaths due to these cancers.(1)  For these cancers, it has been accepted that early detection is beneficial.  Is lung cancer different?  Internationally, lung cancer is thought to be the number one cancer killer.(2)  It is the number one cause of cancer deaths (160,000) in the United States(3) and most of the western nations.  One estimate is that there are 500,000 deaths per year in China due to lung cancer (3).  That number is likely to increase in East Asian countries as the current smoking rate is very high.  Accordingly, there is a tremendous need for an early method of detection when the cancer is potentially treatable for cure.  Presently in Western Europe and North America only 10-20% of patients with lung cancer are diagnosed with stage I disease, which is usually asymptomatic.  Symptomatic lung cancer is usually advanced stage disease so if we are going to make progress then we need to diagnose patients before they are symptomatic.              In the past 10 years, trials have been conducted with spiral CT scans in an effort to diagnose and treat early lung cancer.  Those trials have demonstrated some promising results and associated risks.

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