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Showing content from https://pubmed.ncbi.nlm.nih.gov/29374513/ below:

Screening for Lung Cancer: CHEST Guideline and Expert Panel Report

Practice Guideline

. 2018 Apr;153(4):954-985. doi: 10.1016/j.chest.2018.01.016. Epub 2018 Feb 17. Screening for Lung Cancer: CHEST Guideline and Expert Panel Report

Affiliations

¹ Respiratory Institute, Cleveland Clinic, Cleveland, OH. Electronic address: mazzonp@ccf.org.
² Division of Pulmonary and Critical Care, Department of Medicine, Medical University of South Carolina, Charleston, SC.
³ CHEST, Glenview, IL.
⁴ Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
⁵ VHA National Center for Health Promotion and Disease Prevention, Durham, NC.
⁶ Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, MA; The Pulmonary Center, Boston University School of Medicine, Boston, MA.
⁷ VA Greater Los Angeles Healthcare System, Los Angeles, CA.
⁸ Section of Thoracic Surgery, Department of Surgery, Yale University, New Haven, CT.

PMID: 29374513
DOI: 10.1016/j.chest.2018.01.016

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Practice Guideline

Screening for Lung Cancer: CHEST Guideline and Expert Panel Report

Peter J Mazzone et al. Chest. 2018 Apr.

. 2018 Apr;153(4):954-985. doi: 10.1016/j.chest.2018.01.016. Epub 2018 Feb 17. Affiliations

¹ Respiratory Institute, Cleveland Clinic, Cleveland, OH. Electronic address: mazzonp@ccf.org.
² Division of Pulmonary and Critical Care, Department of Medicine, Medical University of South Carolina, Charleston, SC.
³ CHEST, Glenview, IL.
⁴ Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
⁵ VHA National Center for Health Promotion and Disease Prevention, Durham, NC.
⁶ Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, MA; The Pulmonary Center, Boston University School of Medicine, Boston, MA.
⁷ VA Greater Los Angeles Healthcare System, Los Angeles, CA.
⁸ Section of Thoracic Surgery, Department of Surgery, Yale University, New Haven, CT.

PMID: 29374513
DOI: 10.1016/j.chest.2018.01.016

Item in Clipboard

Abstract

Background: Low-dose chest CT screening for lung cancer has become a standard of care in the United States in the past few years, in large part due to the results of the National Lung Screening Trial. The benefit and harms of low-dose chest CT screening differ in both frequency and magnitude. The translation of a favorable balance of benefit and harms into practice can be difficult. Here, we update the evidence base for the benefit, harms, and implementation of low radiation dose chest CT screening. We use the updated evidence base to provide recommendations where the evidence allows, and statements based on experience and expert consensus where it does not.

Methods: Approved panelists developed key questions using the PICO (population, intervention, comparator, and outcome) format to address the benefit and harms of low-dose CT screening, as well as key areas of program implementation. A systematic literature review was conducted by using MEDLINE via PubMed, Embase, and the Cochrane Library. Reference lists from relevant retrievals were searched, and additional papers were added. The quality of the evidence was assessed for each critical or important outcome of interest using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Important clinical questions were addressed based on the evidence developed from the systematic literature review. Graded recommendations and ungraded statements were drafted, voted on, and revised until consensus was reached.

Results: The systematic literature review identified 59 studies that informed the response to the 12 PICO questions that were developed. Key clinical questions were addressed resulting in six graded recommendations and nine ungraded consensus based statements.

Conclusions: Evidence suggests that low-dose CT screening for lung cancer results in a favorable but tenuous balance of benefit and harms. The selection of screen-eligible patients, the quality of imaging and image interpretation, the management of screen-detected findings, and the effectiveness of smoking cessation interventions can affect this balance. Additional research is needed to optimize the approach to low-dose CT screening.

Keywords: evidence-based medicine; guidelines; lung cancer.

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Comment in

Reservations Regarding Lung Cancer Screening Guidelines.
Reich JM. Reich JM. Chest. 2018 Sep;154(3):715-716. doi: 10.1016/j.chest.2018.06.026. Chest. 2018. PMID: 30195351 No abstract available.
Response.
Mazzone PJ, Silvestri GA, Patel S, Kanne JP, Kinsinger LS, Wiener RS, Soo Hoo GW, Detterbeck FC. Mazzone PJ, et al. Chest. 2018 Sep;154(3):716-717. doi: 10.1016/j.chest.2018.06.025. Chest. 2018. PMID: 30195352 No abstract available.
Consideration of Occupational and Environmental Lung Carcinogen Exposures for Lung Cancer Screening Using Low-Dose Chest CT.
de la Hoz RE, Weissman DN. de la Hoz RE, et al. Chest. 2018 Oct;154(4):996-997. doi: 10.1016/j.chest.2018.07.023. Chest. 2018. PMID: 30290946 Free PMC article. No abstract available.
Response.
Mazzone PJ, Silvestri GA, Patel S, Kanne JP, Kinsinger LS, Wiener RS, Soo Hoo GW, Detterbeck FC. Mazzone PJ, et al. Chest. 2018 Oct;154(4):997-998. doi: 10.1016/j.chest.2018.07.024. Chest. 2018. PMID: 30290947 No abstract available.