Risk for False-Positive Lung Cancer Screening Is Substantial

Nine percent of patients with false-positives on computed tomography required invasive testing.

Despite lack of proven efficacy, lung cancer screening has been widely promoted. In the ongoing National Lung Screening Trial (NLST), about 50,000 current or former smokers have been randomized to screening by either chest x-ray or computed tomography (CT).

In a preparative feasibility study for the NLST, 3318 current or past smokers (age range, 55–74) were randomly assigned to receive annual chest radiography or annual low-dose CT. A false-positive was defined as a positive test result followed by a negative completed work-up or no diagnosis of lung cancer within 12 months. After two screening tests 1 year apart, risk for a false-positive result was 15% for participants in the chest radiography group and 33% for those in the CT group. Four …

Reviewing Author

Richard Saitz, MD, MPH, FACP, FASAM