As we accrue more data on the benefits and harms from cancer screening, it is clear that the benefits do not always exceed the harms. This imbalance is particularly at issue in lung cancer screening by low-dose computed tomography (LDCT), for which 1 randomized clinical trial found a mortality benefit in high-risk smokers and ex-smokers,1 but 3 other randomized clinical trials found no benefit.2-4 In addition, data from the National Health Interview Survey show that most people undergoing screening for lung cancer do not fall in the recommended groups, and thus their harms of LDCT, including radiation exposure, will likely exceed the benefits.5
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I would be interested in a similar shared decision making study with PSA testing. Based upon my own experience, the results would likely be as disappointing as with lung cancer screening.
Redberg RF. Failing Grade for Shared Decision Making for Lung Cancer Screening. JAMA Intern Med. 2018;178(10):1295–1296. doi:10.1001/jamainternmed.2018.3527
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