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Does lung cancer screening with chest X-ray improve disease-free survival?

^a Department of Cardiothoracic Surgery Centre, Guy's Hospital, St Thomas Street, London, SE1 7EH, UK
^b Information Scientist, Royal College of Surgeons of England, Lincolns Inn Fields, London, UK

*Corresponding author. Tel.: +44 207 928 203; fax: +44 207 188 7703.

E-mail address: ian.hunt{at}gstt.nhs.uk (I. Hunt).

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether screening an asymptomatic person with a routine chest X-ray would detect lung cancer early and, most importantly, improve that person's disease-free survival from lung cancer. Altogether 136 papers were identified using the search below. Ten papers presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of the papers are tabulated. We conclude that despite methodological criticisms and concerns regarding biases inherent to screening studies, there is currently no evidence to support the use of chest X-ray to screen an asymptomatic person for lung cancer.

Key Words: Evidence-based medicine; Lung neoplasms; Mass screening; Tomography