Abstract

The mortality from lung cancer exceeds that from breast, colorectal and pancreatic cancer combined. This is because three-quarters of patients present with late-stage disease when treatment is palliative and survival is short. If detected early, lung cancer can be cured, so screening would seem to be an important intervention. Until the publication of the National Lung Screening Trial (NLST),1 there was no evidence to support the implementation of screening with low-dose CT (LDCT). This publication has sparked a different approach to the subject from asking whether it works to what we still need to know to implement with the least harm and cost. These remaining issues will be reviewed.

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