Is Annual Lung Cancer Screening Necessary for All High-Risk Adults?

Adults who are at high risk but have negative CT screen for lung cancer may not require annual screening, according to findings from a retrospective analysis.

While annual low-dose CT screening has been recommended for high-risk patients, the necessity of screening in all eligible adults is uncertain.
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To examine whether frequent screening could be justified, researchers conducted a retrospective cohort analysis of data from a randomized, multicenter screening trial comparing 3 annual low-dose CT and 3 radiographs for the detection of lung cancer in high-risk individuals.

Participants were followed for up to 5 years after their last screen. Researchers examined the incidence of lung cancer and whether detection of lung cancer results from annual screening.

Overall, when the participants who received initial negative screens (n=19,066) were compared against the original cohort (N=26,231), researchers found that the overall incidence rate of cancer and cancer-related mortality rates were lower. Those with negative screens had only one third the rate of cancer incidence at the second screen compared to incidence at the first screen for all participants.

“Participants with a negative low-dose CT prevalence screen had a lower incidence of lung cancer and lung cancer-specific mortality than did all participants who underwent a prevalence screen. Because overly frequent screening has associated harms, increasing the interval between screens in participants with a negative low-dose CT prevalence screen might be warranted.”

—Michael Potts

Reference:

Patz Jr EF, Greco E, Gatsonis C, et al. Lung cancer incidence and mortality in National Lung Screening Trial participants who underwent low-dose CT prevalence screening: a retrospective cohort analysis of a randomised, multicentre, diagnostic screening trial. Lancet Oncology. March 18, 2016 [epub ahead of print]. DOI: http://dx.doi.org/10.1016/S1470-2045(15)00621-X