Lung cancer screening with low dose computed tomography (LDCT): looking back and moving forward

The last 5 years have been a busy time for lung cancer screening. In 2010, results from the National Lung Screening Trial were announced: the trial demonstrated that annual screening with low dose computed tomography (LDCT) led to a 20% reduction in lung cancer mortality for individuals aged 55 to 74 years who had a smoking history of at least 30 pack-years, and if former smokers, had quit within 15 years of enrollment (1). And in 2011, the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial reported no reduction in lung cancer mortality with annual single view chest X-ray screening in either ever or never smokers (2). The results of the trials are generally accepted to have definitively answered two questions that had the subject of much debate over the years. When it comes to lung cancer screening, chest X-ray doesn’t work, but LDCT does.