Repeated methodological flaws in published research result in misinformation that may cause eligible patients to forego or not be offered lung cancer screening, according to a joint publication from the Society of Thoracic Surgeons (STS), American Society for Radiation Oncology (ASTRO), and American College of Radiology (ACR). The statement was published in all three’ societies respective flagship journals: Annals of Thoracic Surgery; the International Journal of Radiation Oncology, Biology, Physics; and the Journal of the American College of Radiology.
Lung cancer kills more people in the United States each year than breast, colon and prostate cancers combined. Annual screening of high risk patients with low-dose computed tomography (CT) scans was proven by multiple renowned studies—such as a 2011 study from the National Lung Screening Trial Research Team, and the 2020 NELSON trial—to significantly reduce lung cancer deaths. However, per research from 2017 and 2020, less than 18.2% of eligible persons are screened.
"Lung cancer screening saves lives. Multiple high-quality studies have clearly demonstrated its benefit. Despite this strong evidence, persistent misinformation about perceived harms continues to limit the uptake of this life-saving test,” said Elliot Servais, MD, FACS, study author and Interim Chair of the Department of Surgery at Lahey Hospital & Medical Center. “In this paper, we address these misconceptions head-on, with the goal of expanding access to screening and saving more lives from lung cancer."
The statement highlights three specific examples that may contribute to reduced screening knowledge and access:
- Overestimation of downstream imaging and procedural complications after lung cancer screening
- Misrepresentation of the lung cancer screening false-positive rate
- Flawed analysis of oncogenic risk associated with radiation from CT scans.
STS, ASTRO, and ACR urge clinicians and researchers to be mindful of these methodological pitfalls when interpreting lung cancer screening data, and encourage journals and the medical community to perform similarly informed, diligent peer review.
“The multispecialty joint statement demystifies the common misunderstandings about the benefits and risks of lung screening and should increase decision-making quality and screening rate,” said Ruth C. Carlos, MD, MS, Editor-in-Chief of the Journal of the American College of Radiology.
DISCLOSURE: For full disclosures of the study authors, visit jacr.org.
