Lung cancer screening Early diagnosis with low-dose computed tomography

Background: Numerous randomised studies have shown a reduction in lung cancer mortality through screening with low-dose computed tomography (CT).Methods: The organisational and structural requirements for achieving a favourable risk-benefit ratio in lung cancer screening were developed with scientists from the German Federal Office for Radiation Protection (BfS) and an expert group from radiology, pneumology, thoracic surgery and epidemiology, as well as delegates from the Federal Joint Committee (G-BA) and the Institute for Quality and Efficiency in Health Care (IQWiG).Results: After consultation with the expert group, the BfS is preparing a report to the Federal Ministry for the Environment (BMU), on the basis of which the BMU is expected to approve lung cancer screening with low-dose CT as the first application of ionising radiation for the early detection of non-contagious diseases under the new law. As previous studies have shown, circumscribed benign lung lesions are common, so measures are needed to keep the number of biopsies of benign lung lesions as low as possible. Lung cancer screening in Germany will probably take place in an interdisciplinary network, in which both the inclusion of the participants, professional support for smoking cessation and the performance of the CT will take place close to home, but the evaluation of the examinations, interdisciplinary decisions and therapy will take place in certified lung cancer centres.Conclusion: Lung cancer screening makes high organisational demands in order to minimise the number of biopsies due to false-positive findings and can only succeed under continuous epidemiological monitoring and, if necessary, adaptation of the procedures.