• Martin Reck, Sabine Dettmer, Hans-Ulrich Kauczor, Rudolf Kaaks, Niels Reinmuth, and Jens Vogel-Claussen.
• Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL); Institute for Diagnostic and Interventional Radiology, Hanover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hanover (BREATH), German Center for Lung Research (DZL); Institute for Diagnostic and Interventional Radiology, Heidelberg University Hospital, Translational Lung Research Center (TLRC), German Center for Lung Research (DZL); German Cancer Research Center (DKFZ), Heidelberg, Translational Lung Research Center (TLRC), German Center for Lung Research (DZL); Department for Thoracic Oncology, Asklepios Specialist Clinics Munich-Gauting, German Center for Lung Research (DZL).
• Dtsch Arztebl Int. 2023 Jun 9; 120 (23): 387392387-392.

BackgroundApproximately 21 900 women and 35 300 men developed lung cancer in Germany in 2018, and 16 514 women and 28 365 men died of it. The outcome mainly depends on the tumor stage. In early stages (stage I or II), treatment can be curative; unfortunately, because early-stage lung cancers are generally asymptomatic, 74% of women and 77% of men already have advanced-stage disease (stage III or IV) at the time of diagnosis. Screening with low-dose computed tomography is an option enabling early diagnosis and curative treatment.MethodsThis review is based on pertinent articles retrieved by a selective search of the literature on screening for lung cancer.ResultsIn the studies of lung cancer screening that have been published to date, sensitivity ranged from 68.5% to 93.8%, and specificity from 73.4% to 99.2%. A meta-analysis by the German Federal Office for Radiation Protection revealed a 15% reduction in lung cancer mortality when low-dose computed tomography was used in persons who were judged to be at high risk for lung cancer (risk ratio [RR] 0.85, 95% confidence interval [0.77; 0.95]). 1.9% of subjects died in the screening arm of the metaanalysis, and 2.2% in the control group. The observation periods ranged from 6.6 to 10 years; false-positive rates ranged from 84.9% to 96.4%. Malignant findings were confirmed in 45% to 70% of the biopsies or resective procedures that were performed.ConclusionSystematic lung cancer screening with low-dose CT lowers mortality from lung cancer in (current or former) heavy smokers. This benefit must be weighed against the high rate of false-positive findings and overdiagnoses.

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