Lung cancer is among the most frequently diagnosed
cancers worldwide and the leading cause of
cancer death in both
males and
females.
Screening for
lung cancer coupled with earlier intervention has long been studied as an approach to
mortality reduction. However, minimal progress was achieved until recently, when lowdose
spiral computed tomography (LDCT)
screening demonstrated a 20% reduction in
mortality from
lung cancer in a
randomized controlled trial (RCT), the National
Lung Screening Trial, from the
United States. On the basis of this finding, LDCT has been recommended for
lung cancer screening in high-
risk populations by several
clinical guidelines. However, results from the following independent RCTs in
Europe failed to show consistent conclusions. In addition, intractable problems gradually emerged with the progress of LDCTscreening. This
paper summarizes and discusses the main observations and challenges of LDCT
screening for
lung cancer. Before spreading implementation of LDCTscreening, challenges, including high false-positive rates,
overdiagnosis, enormous
costs, and
radiation risk, must be addressed. Complementary
biomarkers and technical improvement are expected in the field of
lung cancer screening in the near
future.