The major roadblock in the use of X-ray screening has been that it has not demonstrated any significant reduction in the mortality rate. Recently Strauss et al., 4 after reviewing the data of some of the most important randomized, controlled trials, 5- 11 stated that the effectiveness of CXR screening was underestimated in its ability to reduce the risk of death from lung carcinoma. 1- 3 This consideration, however, is now coming under increased scrutiny. There is widespread acceptance that screening for the early detection of lung carcinoma is not indicated, because no randomized trials have demonstrated a reduction in mortality rate as a result of screening. © 2000 American Cancer Society.Ĭhest X-ray (CXR) screening for lung carcinoma (radiography performed to detect presymptomatic disease) is the most important tool for secondary prevention. The authors conclude that radiographic screening is the only valid method of secondary prevention in cigarette smokers. In the authors' opinion, the considerable improvements in distribution by disease stage, tumor resectability, and patient survival in the screened groups demonstrate the effectiveness of chest X-ray screening in the early detection of lung carcinoma. RESULTSĪ careful analysis of randomized, controlled trials showed that there was no improvement in the mortality rate in the screened populations, but there is considerable evidence that chest X-ray screening is associated with earlier detection and improved survival. Accordingly, no organization that formulates screening policy advocates any specific early detection strategies for lung carcinoma. None of the four randomized, controlled trials on lung carcinoma screening conducted in male cigarette smokers demonstrated a reduction in the mortality rate. The authors reviewed the most important studies published in the literature regarding the role of chest X-ray screening in the early diagnosis of lung carcinoma in a high risk population. Despite this, medical public policy holds that chest X-ray screening is ineffective in the early detection of lung carcinoma. The incidence and mortality rates of lung carcinoma have been increasing during the last years.
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