Screening for lung cancer with low-dose spiral computed tomography

Lung cancer is the number one cancer killer in North America. Currently, screening for lung cancer is not recommended. Therefore, patients will not be diagnosed until they present with symptomatic disease, which is usually advanced stage disease. Previous trials of screening with chest roentgenograms and sputum cytology have failed to show a decrease in lung cancer mortality. Recent reports of screening with low dose spiral CT have detected lung cancers at a smaller size, average of 1.5 cm, than those usually detected by chest radiographs (mean of 3.0 cm). Spiral CT has been shown to detect between 58% and 85% of non-small cell lung cancers while they are stage IA and this compares favorably to the current medical practice where only 15% are detected as localized disease (SEER data). This article summarizes the spiral CT screening data and emphasizes the results of the Mayo Clinic spiral CT screening trial.