Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Aug 28, 2015; 7(8): 189-193
Published online Aug 28, 2015. doi: 10.4329/wjr.v7.i8.189
Lung cancer screening: Computed tomography or chest radiographs?
Edwin JR van Beek, Saeed Mirsadraee, John T Murchison
Edwin JR van Beek, Saeed Mirsadraee, Clinical Research Imaging Centre, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
Edwin JR van Beek, Saeed Mirsadraee, John T Murchison, Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Edwin JR van Beek, MD, PhD, FRCR, FRCPE, Professor, Clinical Research Imaging Centre, Queen’s Medical Research Institute, University of Edinburgh, CO.19, CRIC, QMRI, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom. edwin-vanbeek@ed.ac.uk
Telephone: +44-131-2427760 Fax: +44-131-2427773
Received: March 30, 2015
Peer-review started: April 4, 2015
First decision: April 27, 2015
Revised: April 29, 2015
Accepted: May 27, 2015
Article in press: May 28, 2015
Published online: August 28, 2015

Worldwide, lung cancer is the leading cause of mortality due to malignancy. The vast majority of cases of lung cancer are smoking related and the most effective way of reducing lung cancer incidence and mortality is by smoking cessation. In the Western world, smoking cessation policies have met with limited success. The other major means of reducing lung cancer deaths is to diagnose cases at an earlier more treatable stage employing screening programmes using chest radiographs or low dose computed tomography. In many countries smoking is still on the increase, and the sheer scale of the problem limits the affordability of such screening programmes. This short review article will evaluate the current evidence and potential areas of research which may benefit policy making across the world.

Keywords: Lung cancer, Chest radiograph, Computed tomography, Screening, Health economics

Core tip: The use of low dose computed tomography (CT) for lung cancer screening is superior to the use of standard chest radiograph (CXR), and therefore standard CXR should not be used for this purpose. However, the application of novel computer assisted diagnosis software may influence the utility of CXR and may ultimately be a cost-efficient method in those countries where delivery of low-dose CT is not feasible due to infrastructure or costs constraints.