Lung Cancer Screening: Insights from a Thriving Clinical Practice

Abstract

Lung cancer is the leading cause of cancer deaths in the USA. Computed tomography (CT) offers the potential for early detection by screening asymptomatic high-risk patients. We aimed to review the benefits and potential harms of lung cancer screening, discuss the logistics of a screening program, and provide insight from our own experience. The National Lung Screening Trial (NLST), a large population-based study, has demonstrated mortality benefit from screening, but relatively few eligible patients currently participate. An effective screening program requires input and cooperation from multiple stakeholders. Effort should be made to actively engage patients in the process including a thorough discussion of benefits and possible harms. At our institution, this approach has resulted in a rapidly growing and sustainable program. Lung cancer screening has proven mortality benefit in high-risk patients but is underutilized. Developing and growing a screening program is a complex process requiring coordination among multiple specialties with a focus on patient autonomy.