Screening for Lung Cancer with Chest X-Ray and/or Sputum Cytology
        Benefits
        Harms
Screening for Lung Cancer with Low-Dose Helical Computed Tomography
        Benefits
        Harms

Separate PDQ summaries on Prevention of Lung Cancer, Small Cell Lung Cancer Treatment, Non-Small Cell Lung Cancer Treatment, and Levels of Evidence for Cancer Screening and Prevention Studies are also available.

Based on fair evidence, screening does not reduce mortality from lung cancer.

Level of Evidence

A. Study Design: (Level of Evidence 1)

1: Evidence obtained from randomized controlled trials.

B. Internal Validity: Fair, due to lack of unscreened groups and contamination.

C. Consistency: Good.

D. Direction and Magnitude of Effect: No evidence of effect.

E. External Validity: Fair, due to lack of women and minority groups.

Based on good evidence, screening would lead to false-positive tests and unnecessary invasive diagnostic procedures and treatments.

Level of Evidence

A. Study design: (Level of Evidence 1)

1: Evidence obtained from randomized controlled trials.

B. Internal Validity: Fair.

C. Consistency: Good.

D. Direction and Magnitude of Effect: False-positive results range from 4% to 15%; there is a possibility of overdiagnosis and overtreatment (magnitude uncertain).

E. External Validity: Fair, due to lack of women and minority groups.

The evidence is insufficient to determine whether screening reduces mortality from lung cancer.

Level of Evidence

A. Study Design: (Level of Evidence 3)

3: Evidence obtained from cohort or case-control studies.

B. Internal Validity: Poor for answering the question of mortality reduction from screening with low-dose helical computed tomography.

C. Consistency: Good.

D. Direction and Magnitude of Effect: Cannot determine from the available studies.

E. External Validity: Not applicable, as the internal validity of the evidence is poor.

Based on good evidence, screening would lead to false-positive tests and unnecessary invasive diagnostic procedures and treatments.

Level of Evidence

A. Study Design: (Level of Evidence 3)

3: Evidence obtained from cohort or case-control studies.

B. Internal Validity: Poor.

C. Consistency: Good.

D. Direction and Magnitude of Effect: False-positive results range from 20% to 50%; overdiagnosis and overtreatment are possible (magnitude uncertain).

E. External Validity: Not applicable, as internal validity is poor.

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