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Life Guide U.S. essentials
English

Heavy smokers should get a low-dose chest CT every year

  • High value
  • Evidence A
  • Buys life
  • For: Age 35+
  • Costs a little
  • Takes minutes
  • No willpower

In plain words

Eligible heavy smokers who get a low-dose CT every year have a 20% lower chance of dying of lung cancer than those who get only a chest X-ray, and a 6.7% lower chance of dying overall. The price is follow-up testing after a suspicious result, and the worry during that time.

Cost

One scan costs 200 to 400 CNY and takes 10 minutes. Also count the follow-up after a false alarm, and the worry during that time.

What you get

The U.S. NLST randomized trial enrolled 53,454 people, all aged 55 to 74, with a smoking history of 30 pack-years or more and who had quit no more than 15 years earlier. A pack-year is a unit for smoking amount: one pack a day for one year is one pack-year. The result: people who had a low-dose CT had a 20.0% relative reduction in lung cancer death compared with people who had only a chest X-ray (95% CI 6.8 to 26.7, the plausible range). Overall mortality fell 6.7% in relative terms (95% CI 1.2 to 13.6).

Notes

This applies only to high-risk smokers. In the same trial, 24.2% of the people who had a low-dose CT got a suspicious result, and 96.4% of those turned out to be false alarms (false positives). For a nonsmoker, having this test is paying money to buy anxiety.

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. National Lung Screening Trial Research Team (2011). Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1102873

Mentioned in

Translated from the Chinese original. Original book, section 1, tip 24. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer