Lung cancer screening: current knowledge, opportunities, and challenges

Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA A Cancer J Clinicians. 2024;74(3):229–63. https://doi.org/10.3322/caac.21834.

Article  Google Scholar 

Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023–75. https://doi.org/10.1016/S0140-6736(17)33326-3.

Article  PubMed  PubMed Central  Google Scholar 

De Koning HJ, Van Der Aalst CM, De Jong PA, et al. Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial. n Engl J Med. 2020;382(6):503–13. https://doi.org/10.1056/NEJMoa1911793.

Article  PubMed  Google Scholar 

The National Lung Screening Trial Research Team.. Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. n Engl J Med. 2011;365(5):395–409. https://doi.org/10.1056/NEJMoa1102873.

Article  PubMed Central  Google Scholar 

Kauczor HU, Von Stackelberg O, Nischwitz E, et al. Strengthening lung cancer screening in Europe: fostering participation, improving outcomes, and addressing health inequalities through collaborative initiatives in the SOLACE consortium. Insights Imaging. 2024;15(1):252. https://doi.org/10.1186/s13244-024-01814-5.

Article  PubMed  PubMed Central  Google Scholar 

Ledda RE, Funk GC, Sverzellati N. The pros and cons of lung cancer screening. Eur Radiol. 2024;35(1):267–75. https://doi.org/10.1007/s00330-024-10939-6.

Article  PubMed  PubMed Central  Google Scholar 

Silva M, Prokop M, Jacobs C, et al. Long-Term Active Surveillance of Screening Detected Subsolid Nodules is a Safe Strategy to Reduce Overtreatment. J Thorac Oncol. 2018;13(10):1454–63. https://doi.org/10.1016/j.jtho.2018.06.013.

Article  PubMed  Google Scholar 

Scholten ET, De Jong PA, De Hoop B, et al. Towards a close computed tomography monitoring approach for screen detected subsolid pulmonary nodules? Eur Respir J. 2015;45(3):765–73. https://doi.org/10.1183/09031936.00005914.

Article  PubMed  Google Scholar 

Meza R, Cao P, Jeon J, et al. Impact of Joint Lung Cancer Screening and Cessation Interventions Under the New Recommendations of the U.S. Preventive Services Task Force. J Thorac Oncol. 2022;17(1):160–6. https://doi.org/10.1016/j.jtho.2021.09.011.

Article  PubMed  Google Scholar 

Cadham CJ, Jayasekera JC, Advani SM, et al. Smoking cessation interventions for potential use in the lung cancer screening setting: A systematic review and meta-analysis. Cancer Treat Res. 2019;135:205–16. https://doi.org/10.1016/j.lungcan.2019.06.024.

Article  Google Scholar 

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. https://doi.org/10.1001/jama.2021.0377.

Article  PubMed  Google Scholar 

Rasmussen JF, Siersma V, Malmqvist J, Brodersen J. Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study. Bmj Open. 2020;10(6):e34682. https://doi.org/10.1136/bmjopen-2019-034682.

Article  PubMed  PubMed Central  Google Scholar 

Callister MEJ, Sasieni P, Robbins HA. Overdiagnosis in lung cancer screening. Lancet Respir Med. 2021;9(1):7–9. https://doi.org/10.1016/S2213-2600(20)30553-1.

Article  PubMed  PubMed Central  Google Scholar 

Brodersen J, Schwartz LM, Heneghan C, O’Sullivan JW, Aronson JK, Overdiagnosis WS. what it is and what it isn’t. bmj Ebm. 2018;23(1):1–3. https://doi.org/10.1136/ebmed-2017-110886.

Article  Google Scholar 

Pozzessere C, Von Garnier C, Beigelman-Aubry C. Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned? Tomography. 2023;9(1):166–77. https://doi.org/10.3390/tomography9010015.

Article  PubMed  PubMed Central  Google Scholar 

Field JK, Vulkan D, Davies MPA, Duffy SW, Gabe R. Liverpool Lung Project lung cancer risk stratification model: calibration and prospective validation. Thorax. 2021;76(2):161–8. https://doi.org/10.1136/thoraxjnl-2020-215158.

Article  PubMed  Google Scholar 

Bach PB, Kattan MW, Thornquist MD, et al. Variations in Lung Cancer Risk Among Smokers. Jnci: J Natl Cancer Inst. 2003;95(6):470–8. https://doi.org/10.1093/jnci/95.6.470.

Article  PubMed  Google Scholar 

Tammemagi MC, Schmidt H, Martel S, et al. Participant selection for lung cancer screening by risk modelling (the Pan-Canadian Early Detection of Lung Cancer [PanCan] study): a single-arm, prospective study. Lancet Oncol. 2017;18(11):1523–31. https://doi.org/10.1016/S1470-2045(17)30597-1.

Article  PubMed  Google Scholar 

Chang GC, Chiu CH, Yu CJ, et al. Low-dose CT screening among never-smokers with or without a family history of lung cancer in Taiwan: a prospective cohort study. Lancet Respir Med. 2024;12(2):141–52. https://doi.org/10.1016/S2213-2600(23)00338-7.

Article  PubMed  Google Scholar 

McRonald FE, Yadegarfar G, Baldwin DR, et al. The UK Lung Screen (UKLS): Demographic Profile of First 88,897 Approaches Provides Recommendations for Population Screening. Cancer Prev Res. 2014;7(3):362–71. https://doi.org/10.1158/1940-6207.CAPR-13-0206.

Article  Google Scholar 

Snoeckx A, Silva M, Prosch H, et al. Lung cancer screening with low-dose CT: definition of positive, indeterminate, and negative screen results. A nodule management recommendation from the European Society of Thoracic Imaging. Eur Radiol. 2025; https://doi.org/10.1007/s00330-025-11648-4.

Article  PubMed  PubMed Central  Google Scholar 

International Early Lung Cancer Action Program: Screening Protocol https://www.ielcap.org/wp-content/uploads/2023/05/ielcap-protocol.pdf. Accessed 22 Aug 2025.

Christensen J, Prosper AE, Wu CC, et al. ACR Lung-RADS v2022: Assessment Categories and Management Recommendations. Chest. 2024;165(3):738–53. https://doi.org/10.1016/j.chest.2023.10.028.

Article  PubMed  Google Scholar 

Prokop M, Schaefer-Prokop C, Jacobs C, et al. Aggressiveness-guided nodule management for lung cancer screening in Europe—justification for follow-up intervals and definition of growth. Eur Radiol. 2025; https://doi.org/10.1007/s00330-025-11647-5.

Article  PubMed  PubMed Central  Google Scholar 

Baldwin DR, Callister ME. The British Thoracic Society guidelines on the investigation and management of pulmonary nodules. Thorax. 2015;70(8):794–8. https://doi.org/10.1136/thoraxjnl-2015-207221.

Article  PubMed  Google Scholar 

Oudkerk M, Liu S, Heuvelmans MA, Walter JE, Field JK. Lung cancer LDCT screening and mortality reduction—evidence, pitfalls and future perspectives. Nat Rev Clin Oncol. 2021;18(3):135–51. https://doi.org/10.1038/s41571-020-00432-6.

Article  PubMed  Google Scholar 

Chandrika S, Yarmus L. Recent developments in advanced diagnostic bronchoscopy. Eur Respir Rev. 2020;29(157):190184. https://doi.org/10.1183/16000617.0184-2019.

Article  PubMed  PubMed Central  Google Scholar 

Ledda RE, Milanese G, Revel MP, Snoeckx A. Pros and cons of reporting incidental findings in lung cancer screening. Eur Radiol. 2025; https://doi.org/10.1007/s00330-025-11580-7.

Article  PubMed  PubMed Central  Google Scholar 

Dyer DS, White C, Thomson CC, et al. A Quick Reference Guide for Incidental Findings on Lung Cancer Screening CT Examinations. J Am Coll Radiol. 2023;20(2):162–72. https://doi.org/10.1016/j.jacr.2022.08.009.

Article  PubMed  Google Scholar 

O’Dowd EL, Tietzova I, Bartlett E, et al. ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer. Eur Respir J. 2023;62(4):2300533. https://doi.org/10.1183/13993003.00533-2023.

Article  PubMed  Google Scholar 

Lancaster HL, Zheng S, Aleshina OO, et al. Outstanding negative prediction performance of solid pulmonary nodule volume AI for ultra-LDCT baseline lung cancer screening risk stratification. Cancer Treat Res. 2022;165:133–40. https://doi.org/10.1016/j.lungcan.2022.01.002.

Article  Google Scholar 

Zhao Y, De Bock GH, Vliegenthart R, et al. Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume. Eur Radiol. 2012;22(10):2076–84.

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