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Low-dose CT for lung cancer screening: opportunities and challenges

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Abstract

Lung cancer is among the most frequently diagnosed cancers worldwide and the leading cause of cancer death in both males and females. Screening for lung cancer coupled with earlier intervention has long been studied as an approach to mortality reduction. However, minimal progress was achieved until recently, when lowdose spiral computed tomography (LDCT) screening demonstrated a 20% reduction in mortality from lung cancer in a randomized controlled trial (RCT), the National Lung Screening Trial, from the United States. On the basis of this finding, LDCT has been recommended for lung cancer screening in high-risk populations by several clinical guidelines. However, results from the following independent RCTs in Europe failed to show consistent conclusions. In addition, intractable problems gradually emerged with the progress of LDCTscreening. This paper summarizes and discusses the main observations and challenges of LDCT screening for lung cancer. Before spreading implementation of LDCTscreening, challenges, including high false-positive rates, overdiagnosis, enormous costs, and radiation risk, must be addressed. Complementary biomarkers and technical improvement are expected in the field of lung cancer screening in the near future.

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Acknowledgements

We thank the support from the National Natural Science Foundation of China (Nos. 81521004 and 81230067), the Priority Academic Program for the Development of Jiangsu Higher Education Institutions (Public Health and Preventive Medicine), and the Top-Notch Academic Programs Project of Jiangsu Higher Education Institutions.

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  1. Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China

    Hongbing Shen

  2. Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, 211166, China

    Hongbing Shen

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Correspondence to Hongbing Shen.

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Shen, H. Low-dose CT for lung cancer screening: opportunities and challenges. Front. Med. 12, 116–121 (2018). https://doi.org/10.1007/s11684-017-0600-1

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