Reviewing Lung Cancer Screening The Who, Where, When, Why, and How

Lung cancer screening with annual low-dose computed tomography decreases lung cancer mortality in high-risk patients, defined by smoking history (>30 pack-years) and age (55-74 years). Risks to screening include overdiagnosis, anxiety about indeterminate nodules, and radiation exposure. To be effective, lung cancer screening must combine individualized risk assessment, shared decision making, smoking cessation, structured reporting, high-quality and multispecialty cancer care, and reliable follow-up; a multidisciplinary approach is crucial. Specialty organizations have outlined both the components of high-quality lung cancer screening programs and the proposed metrics that programs should track. Long-term outcomes of lung cancer screening in the general population, further refinement of who to screen, and use of biomarkers for early cancer detection are ongoing research questions.