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World J Radiol. Jul 28, 2020; 12(7): 130-136
Published online Jul 28, 2020. doi: 10.4329/wjr.v12.i7.130
Lung cancer screening, what has changed after the latest evidence?
Juan Carlos Trujillo-Reyes, Luis Seijo, Elisabeth Martínez-Tellez, Felipe Couñago
Juan Carlos Trujillo-Reyes, Elisabeth Martínez-Tellez, Department of Thoracic Surgery, Hospital de la Santa Creu I Sant Pau, Barcelona 08029, Spain
Juan Carlos Trujillo-Reyes, Elisabeth Martínez-Tellez, Department of Surgery, Universitat Autonoma de Barcelona, Barcelona 08029, Spain
Luis Seijo, Department of Pneumology, Clinica Universitaria de Navarra, Madrid 28029, Spain
Felipe Couñago, Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Madrid 28223, Spain
Felipe Couñago, Universidad Europea de Madrid, Madrid 28223, Spain
Felipe Couñago, Department of Radiation Oncology, Hospital La Luz, Madrid 28003, Spain
Author contributions: Trujillo-Reyes JC was involved in the study conceptualization, investigation, data visualization and writing of the original draft; Seijo L performed formal analysis, review and editing of the manuscript; Martinez-Tellez E was involved in the investigation, data visualization and review and editing of the manuscript; Couñago F participated in the investigation, data validation and writing, review and editing of the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: Dr. Seijo reports personal fees from Sabartech, personal fees from Esteve, personal fees from Chiesi, personal fees from Astra Zeneca, grants from Menarini, and speaking fees from Roche, outside the submitted work. Rest of authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Juan Carlos Trujillo-Reyes, MD, Adjunct Professor, Surgical Oncologist, Department of Thoracic Surgery, Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona 08029, Spain. jtrujillo@santpau.cat
Received: March 30, 2020
Peer-review started: March 30, 2020
First decision: April 26, 2020
Revised: June 11, 2020
Accepted: July 1, 2020
Article in press: July 1, 2020
Published online: July 28, 2020
Abstract

Lung cancer (LC) is still one of the most frequent cancers with a high related mortality. Their prognosis is directly proportional to the stage at the time of diagnosis. Seventy percent are currently diagnosed in advanced or locally advanced stage (higher than stage III), making a cure unlikely for the majority of patients. Developments in LC treatment are significant however they do not seem to be enough to reverse the current situation, at least, in a short period of time. Despite recent advances in treatment, primary prevention and early diagnosis appear to be the key to reduce the incidence and mortality of this disease. Many countries have developed LC screening programs based on the results of clinical trials published in recent years. The aim of this paper is to review the latest results of the NEderlands Leuvens Longkanker Screenings Onderzoek and compare them with the findings of the National Lung Screening Trial. We address the question whether it is necessary to continue discussing the evidence regarding LC screening. In both trials, there is a clear impact on LC mortality but, with a modest reduction in over all mortality. Undoubtedly, the benefit of screening can be expected to grow as low-dose computed tomographys are performed over longer periods of time.

Keywords: Lung cancer, Epidemiology, Lung cancer screening, Low dose chest computed tomography scan, Primary prevention, Molecular biomarkers

Core tip: In recent years, many publications have focused on primary prevention and Lung cancer (LC) screening. Currently, most scientific societies recommend some form of LC screening. However, implementation around the world has been slow, at least in part because of a continued controversy regarding some aspects of LC screening. The aim of this article is to analyze the recently published results of the NEderlands Leuvens Longkanker Screenings Onderzoek study and compare them to those of the American National Lung Screening Trial (NLST). There is a clear impact on LC mortality in both trials, but only the NLST revealed a reduction in overall mortality (7%).