Elizabeth E. Warner, MD

Given that there is no validated test for early lung cancer detection,the current standard approach to lung cancer detection is to wait forsigns or symptoms to develop. In that setting, newly detected lung canceris generally rapidly fatal resulting in over 157,000 deaths annually.Sole dependence on tobacco control is an insufficient public healthresponse to lung cancer, since most newly diagnosed individuals areeither former smokers or never smokers. Finding a more effective wayto diagnose premetastatic lung cancer would be a crucial step towardan improved lung cancer-related mortality rate. Based on studies ofbreast cancer screening, we know that achieving optimal benefit fromearly cancer detection also involves defining the most effective, efficient,and safest approach to the clinical management of screen-identifiedlung cancer. In this review, we consider how to build on the successesof other cancer screening efforts to detect and manage earlylung cancer. This involves outlining the specific elements for lung cancerthat could make a screening program safe, affordable, and effective.We also explore the current standards of early lung cancer managementand target areas where potential pitfalls and opportunities forimprovement exist.