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Review
. 2019 Feb 12;11(2):212.
doi: 10.3390/cancers11020212.

Lung Cancer Screening, Towards a Multidimensional Approach: Why and How?

Jonathan Benzaquen  1   2 , Jacques Boutros  3 , Charles Marquette  4   5 , Hervé Delingette  6 , Paul Hofman  7   8
Affiliations
Review

Lung Cancer Screening, Towards a Multidimensional Approach: Why and How?

Jonathan Benzaquen et al. Cancers (Basel). .

Abstract

Early-stage treatment improves prognosis of lung cancer and two large randomized controlled trials have shown that early detection with low-dose computed tomography (LDCT) reduces mortality. Despite this, lung cancer screening (LCS) remains challenging. In the context of a global shortage of radiologists, the high rate of false-positive LDCT results in overloading of existing lung cancer clinics and multidisciplinary teams. Thus, to provide patients with earlier access to life-saving surgical interventions, there is an urgent need to improve LDCT-based LCS and especially to reduce the false-positive rate that plagues the current detection technology. In this context, LCS can be improved in three ways: (1) by refining selection criteria (risk factor assessment), (2) by using Computer Aided Diagnosis (CAD) to make it easier to interpret chest CTs, and (3) by using biological blood signatures for early cancer detection, to both spot the optimal target population and help classify lung nodules. These three main ways of improving LCS are discussed in this review.

Keywords: artificial intelligence; lung cancer; screening.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
“I” nodules, the “grey zone” of lung cancer screening.
Figure 2
Figure 2
Six lung cancer screening cases illustrating to what extent interpretation of low-dose computed tomography may be difficult. NSCLC: non-small cell lung cancer; GGO: ground glass opacities.
Figure 3
Figure 3
Architecture of computer-aided diagnosis systems for lung cancer screening. t1: first screening round. t2: follow-up.
Figure 4
Figure 4
Training CNN for lung cancer screening.
Figure 5
Figure 5
Tumor-derived components that can be used in the setting of lung cancer screening. TEP: tumor-educated platelets; miRNA: microRNA.
Figure 6
Figure 6
Workflow of lung cancer screening.
See this image and copyright information in PMC

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References

    1. National Lung Screening Trial Research Team. Aberle D.R., Adams A.M., Berg C.D., Black W.C., Clapp J.D., Fagerstrom R.M., Gareen I.F., Gatsonis C., Marcus P.M., et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N. Engl. J. Med. 2011;365:395–409. doi: 10.1056/NEJMoa1208962. - DOI - PMC - PubMed
    1. De Koning H.J., Van Der Aalst C.M., Ten Haaf K., Oudkerk M. PL02.05. Effects of Volume CT Lung Cancer Screening: Mortality Results of the NELSON Randomised-Controlled Population Based Trial. J. Thorac. Oncol. 2018;13:S185. doi: 10.1016/j.jtho.2018.08.012. - DOI
    1. Moyer V.A., On behalf of U.S. Preventive Services Task Force Screening for lung cancer: U.S. preventive services task force recommendation statement. Ann. Intern. Med. 2014;160:330–338. doi: 10.7326/M13-2771. - DOI - PubMed
    1. CMS.gov. [(accessed on 3 February 2019)]; Available online: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo....
    1. Oudkerk M., Devaraj A., Vliegenthart R., Henzler T., Prosch H., Heussel C.P., Bastarrika G., Sverzellati N., Mascalchi M., Delorme S., et al. European position statement on lung cancer screening. Lancet Oncol. 2017;18:e754–e766. doi: 10.1016/S1470-2045(17)30861-6. - DOI - PubMed