European radiology
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Lung cancer screening with CT remains controversial. Lung cancer is the leading cause of cancer death. To date, no screening test has been demonstrated to reduce mortality. ⋯ The innumerable small nodules detected with screening CT, and diagnostic chest CT in general, present a daily clinical challenge, and result in extensive medical resource utilization and additional radiation exposure. Algorithms for how and when to follow small nodules detected on CT are in evolution. Ongoing studies are designed to determine if lung cancer screening with CT reduces lung cancer mortality.
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Computed tomographic (CT) cancer screening has seen a steady increase in interest with the introduction of multislice scanners. While the potential benefits of screening are obvious, radiation dose may pose a long-term risk for the screened individual. This article will discuss the basis for radiation risk estimation and give an overview of the current dose controversy surrounding CT screening. ⋯ For both indications substantial dose reduction up to factors of 5-10 may be possible. Full-body screening remains critical when performed at regular intervals because of the large doses required and the direct exposure of the lungs. If performed in a dose-conscious fashion, individual risks with lung and colon cancer screening are very small, but estimated population risks are non-negligible.