Early Detection of Lung Cancer in High Risk Populations

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Abstract
A major question still present in the minds of many physicians is whether pulmonary screening of high risk populations can reduce the death rate from lung cancer. Screening is the presumptive identification of unrecognized lung cancer patients by the use of tests, examinations and other procedures which can be applied rapidly. A screening test is not intended to be diagnostic but is performed on apparently healthy people. It is used on a mass basis, may not be extremely accurate and is relatively inexpensive. A diagnostic test is only performed when there are indications. It is used on an individual basis and is usually more accurate and more expensive than the screening test. The value of any screening procedure will depend on its sensitivity and specificity. Sensitivity refers to the percentage of positive cases identified from the screened population. Specificity relates to the infrequency of diseased persons being screened negative. The chest X-ray and sputum cytology are presently the most accepted screening tests at hand. They have high specificities, but disappointingly low sensitivities. Diagnostic procedures are more sensitive and include fiberoptic bronchoscopy, bronchography, special X-ray studies and biopsy.