Lung Cancer Screening

Question 1

% of lung cancer that cigarette smoking is a cause

Answer 1

85-90%

Question 2

Is there mortality benefit from CXR screening for lung cancer

Answer 2

No

Question 3

Is there mortality benefit from sputum cytology for lung cancer screening

Answer 3

No

Question 4

Two trials that looked at LDCT and lung cancer benefit

Answer 4

NEJM Nation Lung Screening Trial (NSLT) - reduced mortality

NELSON trial - no mortality benefit

Question 5

NSLT guidelines for lung cancer screening

Answer 5

55-74 years old

Current smokers or quit < 15 years

30 pack years

Question 6

USPSTF guidelines for lung cancer screening

Answer 6

50-80 years old

Current smokers or quit < 15 years

20 pack years

Question 7

5 patients who should NOT be screened for lung cancer

Answer 7

History of lung cancer

Chest CT in last 12 months

Hemoptysis

Unexplained weight loss of > 15 lbs

Condition that limits life expectancy or ability to tolerate treatment

Question 8

Average background radiation

Answer 8

3.1 mSV annually

Question 9

LDCT radiation amount

Answer 9

1.5 mSV

Question 10

Average number of lung cancers discovered for every 1 cancer induced by radiation from the scan

Answer 10

108

Question 11

LUNG RADS uses what measurement criteria for size

Answer 11

Average between long and short axis measurements

Question 12

LUNG RADS compared to NLST screening

Answer 12

Lower sensitivity but lower false positive rate