Lung cancer screening is receiving increasing attention worldwide and has been the focus of recent debate. In an article published today in The Lancet Respiratory Medicine, scientists from the International Agency for Research on Cancer (IARC) present a new infographic that illustrates the benefits and harms of lung screening in the United States National Lung Screening Trial. The infographic was developed in collaboration with researchers in the United Kingdom and the USA.
The National Lung Screening Trial offered screening once a year for 3 years with low-dose computed tomography (CT) scans to nearly 27 000 participants. However, the protocols used to interpret the findings have changed since the trial began, and its outcomes no longer represent what is expected in modern screening programmes. Dr Hilary Robbins, a scientist in the IARC Genetic Epidemiology Group, and colleagues analysed screening results from the trial after they were reclassified to reflect the protocol that is currently used to manage screen findings in the USA.
The team estimated that among 1000 eligible individuals screened 3 times, 779 people would be expected to have all normal scans. Furthermore, 180 people would need an extra scan but would not have lung cancer, and 13 of those people would require an invasive procedure to rule out lung cancer. Finally, 41 people would be diagnosed with lung cancer; of those, 4 cancers would never have caused the person harm, and 3 people would avoid dying from lung cancer, thanks to screening.
The full-page infographic developed by the team presents these benefits and harms along with contextual information that may be useful for people who want to learn about lung screening. These results were adapted by The Economist for use in an article and a short film. The team plans to update the results and the infographic as additional lung screening data become available.
Robbins HA, Callister M, Sasieni P, Quaife SL, Cheung LC, Brennan P, et al.
Benefits and harms in the National Lung Screening Trial: expected outcomes with a modern management protocol
Lancet Respir Med, Published online 7 May 2019; https://doi.org/10.1016/S2213-2600(19)30136-5