Am Fam Physician. 2023;107(1):100-102
Author disclosure: No relevant financial relationships.
Key Points for Practice
• Annual LDCT screening of current smokers and those who quit within 15 years of screening between 50 and 80 years of age reduces mortality with a number needed to screen ranging, based on baseline, from 161 to 5,276 to prevent one death over 10 years.
• Risks of LDCT screening include unnecessary additional procedures and procedure complications, including an NNH of 2,500 for death after procedures and an estimated NNH of 2,500 for death caused by radiation exposure from annual screening examinations.
• In patients with multiple comorbidities, the balance between benefit and harm can shift dramatically because benefits are less likely, procedural risks increase, and overdiagnosis becomes more likely.
• Successful LDCT screening programs require multidisciplinary teams to respond to abnormal results using established algorithms.
From the AFP Editors
Lung cancer screening with low-dose computed tomography (LDCT) involves a mix of risks and benefits to individual patients despite consistent evidence of population-level benefit. The American College of Chest Physicians published guidelines for lung cancer screening based on a systematic review.
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