Importance of Individualized Decision Making for Lung Cancer Screening.
Radiology. 2018 Oct;289(1):225-226. doi: 10.1148/radiol.2018181220. Epub 2018 Jul 10.
Lung cancer screening has become well established in the United States. In December 2013, based mainly on the results of the National Lung Screening Trial (NLST) (1), the U.S. Preventive Services Task Force issued a grade B recommendation for lung cancer screening with low-dose CT for those at high risk (2). Shortly thereafter, in February 2015, the Centers for Medicare and Medicaid Services issued a national coverage determination for Medicare coverage conditional on several requirements, including structured reporting of screening results and submission of relevant data to a national registry. In addition, the American College of Radiology has developed a structured reporting system, the Lung CT Screening Reporting and Data System (Lung-RADS), the Lung Cancer Screening Registry, and numerous educational and administrative resources. More recently, the European Union has recommended an implementation plan for lung cancer screening following the anticipated release of mortality data from the Dutch-Belgian Randomized Lung Cancer Screening Trial within the next year (3). However, several important questions about lung cancer screening remain unanswered, such as for how long should screening continue? In the NLST, there were only three annual screening examinations.