Horst, C; Callister, MEJ; Janes, SM; (2019) Low-dose Computed Tomography Screening: The (Other) Lung Cancer Revolution. Clinical Oncology , 31 (10) pp. 697-701. 10.1016/j.clon.2019.07.022.

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Abstract

The advent of immune checkpoint inhibitors for the treatment of metastatic non-small cell lung cancers has been a bright spot in the otherwise bleak landscape of the UK's deadliest cancer. In a disease where two-thirds of those who present with a new diagnosis will be dead within a year, and survival outcomes have changed little in the last four decades [1], the potential to extend progression-free and overall survival by, on average, 4 months [2] is noteworthy. Immunotherapy may play a starring role in the future of lung cancer treatment but there is a more revolutionary approach to improving lung cancer outcomes: low-dose computed tomography (LDCT) screening. Lung cancer screening (LCS) with LDCT demonstrates considerable lung cancer and all-cause mortality risk reduction [3], [4]. LCS and effective and embedded smoking cessation interventions show synergy, with the mortality reduction of screening essentially doubled by prolonged cessation [5]. However, when it comes to LDCT screening, there is still a hearts-and-minds battle to be won (see Table 1).

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