From Chest: What to Do When a Smoker's CT Scan Is "Normal"?: Implications for Lung CancerScreening

http://www.ncbi.nlm.nih.gov/pubmed/22553261

Chest. 2012 May;141(5):1147-52.

What to Do When a Smoker's CT Scan Is "Normal"?: Implications for Lung CancerScreening.

Zurawska JH, Jen R, Lam S, Coxson HO, Leipsic J, Sin DD.

Source

St. Paul's Hospital, University of British Columbia, Room 8442, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada. don.sin@hli.ubc.ca.

Abstract

Lung cancer is the leading cause of cancer-related mortality in the United States and around the world. There are > 90 million current and ex-smokers in the United States who are at increased risk of lung cancer. The published data from the NationalLung Screening Trial (NLST) suggest that yearly screening with low-dose thoracic CT scan in heavy smokers can reducelung cancer mortality by 20% and all-cause mortality by 7%. However, to implement this program nationwide using the NLST inclusion and exclusion criteria would be extremely expensive, with CT scan costs alone > $2 billion per annum. In this article, we offer a possible low-cost strategy to risk-stratify smokers on the basis of spirometry measurements and emphysema scoring by radiologists on CT scans.