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low dose lung CT (LDLCT)

Indications: - USPSTF recommends annual screening for lung cancer with low-dose CT for adults aged 50-80 with a 20-pack-year smoking history who currently smoke or have quit within the past 15 years [1] * see screening for lung cancer Procedure: - non-contrast low-dose spiral CT Adverse effects: - radiation exposure - lifetime risk of radiation-induced cancer from screening is 2.6-8.1 per 10,000 [2] Notes: - the most common incidental findings: [3] - emphysema 43% - coronary artery calcium 12% - mass lesions 7%

General

CT of chest; CT of thorax

References

  1. US Preventive Services Task Force Screening for Lung Cancer. US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(10):962-970. March 9. PMID: 33687470 https://jamanetwork.com/journals/jama/fullarticle/2777244 - Jonas DE, Reuland DS, Reddy SM et al Screening for Lung Cancer With Low-Dose Computed Tomography. Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;325(10):971-987. March 9. PMID: 33687468 https://jamanetwork.com/journals/jama/fullarticle/2777242 - Meza R, Jeon J, Toumazis I et al Evaluation of the Benefits and Harms of Lung Cancer Screening With Low-Dose Computed Tomography: Modeling Study for the US Preventive Services Task Force. JAMA. 2021;325(10):988-997. March 9 PMID: 33687469 https://jamanetwork.com/journals/jama/fullarticle/2777243 - Henderson LM, Rivera MP, Basch E Broadened Eligibility for Lung Cancer Screening. Challenges and Uncertainty for Implementation and Equity. JAMA. 2021;325(10):939-941. March 9 PMID: 33687453 https://jamanetwork.com/journals/jama/fullarticle/2777223 - Colson YL, Shepard JO, Lennes IT. New USPSTF guidelines for lung cancer screening: Better but not enough. JAMA Surg 2021 Mar 9; [e-pub]. PMID: 33687427 https://jamanetwork.com/journals/jamasurgery/fullarticle/2777052 - Fukunaga M et al. The 2021 US Preventive Services Task Force recommendation on lung cancer screening: The more things stay the same... JAMA Oncol 2021 Mar 9; [e-pub] PMID: 33687430 https://jamanetwork.com/journals/jamaoncology/fullarticle/2777056 - Moyer VA et al Screening for Lung Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. Published online 31 December 2013 PMID: 24378917 http://annals.org/article.aspx?articleid=1809422 - Bach PB Raising the Bar for the U.S. Preventive Services Task Force. Ann Intern Med. Published online 31 December 2013 PMID: 24379087 http://annals.org/article.aspx?articleid=1809426 - Detterbeck FC and Unger M Screening for Lung Cancer: Moving Into a New Era. Ann Intern Med. Published online 31 December 2013 PMID: 24379025 http://annals.org/article.aspx?articleid=1809425
  2. Rampinelli C, De Marco P, Origgi D et al Exposure to low dose computed tomography for lung cancer screening and risk of cancer: secondary analysis of trial data and risk-benefit analysis. BMJ 2017;356:j347 PMID: 28179230 Free full text http://www.bmj.com/content/356/bmj.j347
  3. Gareen IF et al. Significant incidental findings in the National Lung Screening Trial. JAMA Intern Med 2023 May 8; [e-pub]. PMID: 37155190 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804380