The Veterans Health Affairs (VHA) lung cancer screening (LCS) demonstration project identified a much higher false-positive rate following initial low-dose computed tomographic screening than did the National Lung Screening Trial (58.2% vs 26.3%).1,2 Most false-positive results (nodules not confirmed to be lung cancer [LC] after follow-up) resulted in repeated imaging, but 2.0% of people screened also required nonbeneficial downstream diagnostic evaluation to determine these nodules were not cancer.2 We sought to put these findings into context by examining how this high false-positive rate influences the harm-to-benefit ratio for higher- vs lower-risk patients.
Caverly TJ, Fagerlin A, Wiener RS, et al. Comparison of Observed Harms and Expected Mortality Benefit for Persons in the Veterans Health Affairs Lung Cancer Screening Demonstration Project. JAMA Intern Med. 2018;178(3):426–428. doi:10.1001/jamainternmed.2017.8170
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