Implementation of a Lung Cancer-Screening Program

The National Lung Screening Trial (NLST) demonstrated that lung cancer screening with three annual low-dose CT scans has the potential to reduce lung cancer-specific mortality by 20 % among a population of older heavy smokers. Many questions should be raised to convert this efficacy into effective clinical practice. Screening for lung cancer will be most effective if it is conducted solely for high-risk individuals that can benefit from cancer treatment. Ongoing screening should be accompanied by continued research into risk modeling, communication strategies, and biomarkers. For clinicians establishing lung cancer screening programs, this should be done responsibly, adhering to practices specified in the design of the NLST, and with careful attention given to proper management of screen-detected abnormalities and maintenance of screening registries.