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March 2018

Reducing Harms in Lung Cancer Screening—Bach to the Future

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco
  • 2Editor, JAMA Internal Medicine
JAMA Intern Med. 2018;178(3):326-327. doi:10.1001/jamainternmed.2017.8217

The US Preventive Services Task Force currently recommends screening (grade B recommendation) for lung cancer with annual low-dose computed tomography for high-risk individuals ages 55 to 80 years, defined as those having greater than a 30 pack-year cumulative smoking history and having quit within the past 15 years.1 The evidence to support this recommendation overwhelmingly comes from the National Lung Cancer Screening Trial (NLST). While 3 other large randomized clinical trials failed to show any mortality benefit to lung cancer screening (LCS), the NLST demonstrated a 20% reduction in lung cancer mortality, along with a 6.7% reduction in all-cause mortality, when compared with an annual chest radiograph, with a number needed to screen (NNS) of 256 to prevent 1 lung-cancer associated death over 3 years.2-5

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