[Protocols for lung cancer screening: Limitations, and consequences]

Abstract

Lung cancer is the leading cause of cancer mortality in the world. Its incidence is still rising, especially in women, and its prognosis is poor with a 5-year survival of 15%. Since 1970, several studies on lung cancer screening have been conducted using different investigations. Screening by chest X-ray and sputum cytology does not lead to improved survival in lung cancer. Screening by CT scan has the same outcome but the detection of lung cancer, especially in its early stages, is better than with chest X-ray and sputum cytology. Fluorescence endoscopy is a valuable examination for the detection of pre-invasive bronchial lesions. Genetic studies and identification of circulating tumour cells are being developed. All these examinations are very stressful for the patients. Only few trials have studied the consequences of lung cancer screening on the quality of life. In this review, we analyze the various screening strategies, their impact on quality of life and health and their adverse effects.