Clinical Question Is screening for lung cancer with low-dose chest computed tomography (CT) cost-effective in high-risk persons? Bottom Line The U.S. Preventive Services Task Force (USPSTF) gave lung cancer screening a B recommendation on the basis of the reductions in disease-specific mortality and all-cause mortality seen in the National Lung Screening Trial (NLST). The NLST does not consider cost or cost-effectiveness in its recommendations. This cost-effectiveness analysis suggests that screening is most cost-effective for current smokers, for patients in their 60s, and for those who are at higher risk of lung cancer. (Level of Evidence = 1b) Synopsis The USPSTF recently gave screening for lung cancer using low-dose chest CT a B recommendation, largely on the basis of the results ...

Summary of Evidence Table 11 provides a summary of the main findings in this evidence review organized by KQ along with a description of consistency, precision, quality, limitations, the strength of evidence, and applicability. Evidence for Benefits and Harms of Screening For the benefits of screening, the good-quality NLST demonstrated a reduction in lung cancer mortality and all-cause mortality with three rounds of annual LDCT screening compared with CXR. Its results indicate an NNS of 323 to prevent one lung cancer death over 6.5 years of follow-up. The fair-quality NELSON trial also demonstrated a reduction in lung cancer mortality, but not all-cause mortality, with four rounds of LDCT screening with increasing intervals; its results indicate a NNS of 130 to ...