American Cancer Society Guidelines for the Early Detection of Cancer Pt.5

TESTING FOR EARLY LUNG CANCER DETECTION :

At present, no organization recommends testing for early lung cancer detection in asymptomatic individuals at risk for lung cancer. However, the growth in the use of spiral computed tomography (CT) to test for early lung cancer detection in former and current smokers, as well as the more common use of chest x-ray, led the ACS to update its narrative about lung cancer testing in 2001 emphasizing the importance of informed decisions among individuals at risk who seek testing.2 The ACS historically has maintained that patients at high risk of lung cancer due to significant exposure to tobacco smoke or occupational exposures may decide to undergo testing for early lung cancer detection on an individual basis after consultation with their physicians.21

The circumstances leading to individual decision making are more challenging today because of growing evidence indicating a possible benefit from testing for early lung cancer detection with spiral CT22,23 and increased discussion of the potential benefits associated with early detection during media coverage of lung cancer diagnoses in well-known individuals.24 Favorable findings from investigations using low-dose helical CT for testing for early lung cancer detection25 led to a large prospective trial evaluating the relative efficacy of low-dose spiral CT versus chest radiography for the early detection of lung cancer in current and former smokers,26 as well as direct promotion to the public of spiral CT for early lung cancer detection. The NCI estimates that the trial may produce end results that could inform policy decisions as early as 2009.

In its narrative, the ACS emphasized the importance of informed decision making for individuals who elect to be tested for early lung cancer detection, and recommend that testing should be done only in experienced centers characterized by multidisciplinary specialty groups with experience in testing, diagnosis and follow-up. Current smokers should be informed that the more immediate preventive health priority is the elimination of tobacco use altogether, because smoking cessation offers the surest route at this time to reducing the risk of premature mortality from lung cancer.27