CHEST Guidelines-Screening-for-Lung-Cancer_2018

Screening-for-Lung-Cancer_2018_chest

Pdf Summary

The CHEST Guideline and Expert Panel Report on lung cancer screening highlights low-dose CT (LDCT) as a standard method in the U.S., largely due to the National Lung Screening Trial results. The guideline evaluates the benefits, harms, and implementation of LDCT, offering evidence-based recommendations and consensus statements.<br /><br />Key findings include the indication that LDCT screening can reduce lung cancer mortality but may result in overdiagnosis and unnecessary procedures due to false positives. The report suggests that LDCT screening is particularly beneficial for current and former smokers aged 55 to 77, with a significant history of smoking (30 pack years or more), who still smoke or have quit within the past 15 years. For those at high risk based on other criteria, routine screening is not suggested due to potential harms outweighing benefits.<br /><br />The guideline emphasizes screening program components: ensuring appropriate patient selection, performing regular evaluations, managing findings systematically, and incorporating smoking cessation interventions. It underscores the necessity of a structured approach to reporting, like the LungRADS system, and proactive management strategies for incidental findings detected through LDCT.<br /><br />Guidance for the implementation of LDCT screening programs includes ensuring readiness, promoting shared decision-making, and incorporating evidence-based tobacco cessation support. Recommendations encourage defining a positive test on LDCT based on nodule size and suggest annual screening where eligible to maintain the correct balance of risks to benefits. Programs should also adhere to specific protocols to ensure imaging quality and minimize radiation risks.<br /><br />Overall, the report argues for further research to optimize account implementations of LDCT screening and support clinicians in making informed decisions. The guideline is intended for healthcare providers, administrators, and policymakers involved in lung cancer screening.

Keywords

lung cancer screening

low-dose CT

National Lung Screening Trial

LDCT benefits

overdiagnosis

smoking cessation

LungRADS system

shared decision-making

nodule size

radiation risks