Lung cancer is the leading cause of cancer-death worldwide. In the United States, The U.S. Preventative Services Task Force (USPTSF) approved screening for current or former smokers aged 55- 80 based on the results of the National Lung Screening trial (NLST). This decision has been criticized for lack of corroborative trials. Following the NLST, new evidence has emerged to support lung cancer screening with low dose computed tomography (LDCT) and the surgical implications.
Multiple new prospective randomized control trials on lung cancer screening support LDCT including the Multicentric Italian Lung Detection (MILD), the German Lung Cancer Screening Intervention trial (LUSI), the UK Lung Screening pilot study (UKLS), and the Nederlands-Leuvens Longkanker Screening Onderzoek (NELSON) trials. Furthermore, the extended results of the NLST trial has provided further insight into the benefits to lung cancer screening with LDCT, especially for women. The use of standardized nodule classifications (lung-RADS and volumetric analysis) reduce harm and lower false positive rates. The use of the emerging field of risk-prediction models can identify individuals that are appropriate for screening with lower tobacco exposures. The downstream effect of screening will require an increase in the thoracic workforce to accommodate the amount of surgically operable cancers.
Dr. Aaron R. Dezube is a general surgery resident in the Department of Surgery at St. Elizabeth’s Medical Center, Boston, USA an affiliate of Tufts University School of Medicine. In addition he is the Jack Mitchell Thoracic Surgery Oncology research fellow in the Division of Thoracic Surgery at Brigham and Women’s Hospital/Harvard Medical School in the Michael T Jaklitsch lab . He is the author and co-author of multiple peer-reviewed publications, as well as contributes as a co-author for multiple articles on UptoDate. His research interests include clinical outcomes in thoracic surgery and lung cancer screening.