Secondary Analysis of the NLST data with simpler comparative methods between CXR and LDCT

Abstract

Abstract: The death rate from lung cancer is highest amongst all cancers; it comprises approximately 20% of all cancer death. After decades of striving to find a screening tool similar to Chest x-ray (CXR) and blood biomarkers for the deadliest cancer in the world, three decades ago, the screening with Low Dose Computed Tomography (LDCT) began. Unless the patient becomes symptomatic with a cough, hemoptysis, weight loss, this cancer was hard to detect. Even though smoking cessation is the best way to reduce mortality and morbidity from lung cancer, LDCT showed its ability to identify lung cancer earlier and thus decrease the death rate from lung cancer in countries that can afford to use this tool. LDCT can decrease all-cause mortality by approximately 7% and lower lung cancer mortality by about 20%. LDCT has high sensitivity when compared to the CXR. In addition to detecting late-stage cancer, LDCT can also detect early-stage lung cancer (stage I), which can decrease mortality as well as morbidity. When first introduced as a screening tool for lung cancer, clinicians and scientists raised concerns about radiation exposure, cost, psychological effects, and high false positive rates. Due to these concerns, countries like the USA and some European countries were hesitant to approve LDCT as a screening tool for two decades. Notwithstanding, in 2013, the United State Preventive Services Task Forces (USPSTF) gave the LDCT a B recommendation as a screening tool for lung cancer.