Lung cancer screening: identifying the high risk cohort

Low dose computed tomography (LDCT) is a viable screening tool for early lung cancer detection and mortality reduction. In practice, the success of any lung cancer screening programme will depend on successful identification of individuals at high risk in order to maximise the benefit-harm ratio. Risk prediction models incorporating multiple risk factors have been recognised as a method of identifying individuals at high risk of developing lung cancer. Identification of individuals at high risk will facilitate early diagnosis, reduce overall costs and also improve the current poor survival from lung cancer. This review summarises the current methods utilised in identifying high risk cohorts for lung cancer as proposed by the Liverpool Lung Project (LLP) risk model, Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial risk models and the prediction model for lung cancer death using quintiles. In addition, the cost-effectiveness of CT screening and future perspective for selecting high risk individuals is discussed.