Lung Cancer Screening: A Need for Adjunctive Testing

Slideshow below.

Early detection of lung cancer by screening with low dose computed tomography (LDCT) scanning has long been investigated as a potential means of reducing related deaths.^1,2 The 2011 National Lung Screening Trial (NLST) compared LDCT scanning with standard chest radiograph (CXR). Results showed a significant reduction in mortality in high-risk current and former smokers who were screened annually (3×) with LDCT scan vs CXR.³

LDCT scanning for lung cancer is currently a standard of care, partially due to the results of the NLST.^4,5 In 2013, LDCT scanning was recommended by the US Preventive Services Task Force (USPSTF), making about 8 million Americans eligible for screening.⁶ In 2019, an extended NLST cohort follow-up study showed that earlier detection with LDCT scanning not only delayed lung cancer death, but also prevented it—or at least delayed it by a decade or more.^4,7 This sparked another change in eligibility criteria in the 2021 USPSTF guidelines, allowing an additional 6.5 million people to be eligible for screening.⁶

Unfortunately, LDCT scanning has some negative aspects to its use, such as high false-positive rates, repeated radiation exposure, and the lack of ability to distinguish between nodules that are benign or malignant.⁸ There is a need for adjunctive testing for screening. Some current research is focusing on the development of liquid biomarkers intended to be complementary to imaging as a method of using noninvasive lung cancer diagnostics.

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