Lung cancer screening : an overview

Lung cancer is a heterogeneous and often aggressive disease. Despite advances in lung cancer treatment and an overall reduction in the rate of heavy smoking over the last half century, lung cancer remains the most common cancer and the leading cause of cancer death worldwide and in Malta. The theoretical benefits of lung cancer screening are clear; it is a common disease with a significant prognostic benefit when detected early. A cheap, noninvasive and widely available screening tool was the major obstacle to large-scale, successful lung cancer screening. Historical attempts at lung cancer screening using chest radiographs with or without cytological analysis of sputum specimens were largely unsuccessful, mainly due to the limitations of chest radiographs in the detection of early-stage lung cancer. The advent of lowdose chest CT (LDCT) around the turn of the millennium led to the establishment of several large-scale trials determining whether screening with LDCT would reduce mortality from lung cancer among high-risk persons.