When the Average Applies to No One: Personalized Decision Making About Potential Benefits of Lung Cancer Screening
Cet article analyse les enjeux associés à la prise de décision personnalisée en matière de dépistage du cancer du poumon
n 2011, four decades of studies of lung cancer screening came to fruition with the publication of the results of the National Lung Screening Trial (NLST). The NLST found that for high-risk individuals, 3 rounds of annual screening with low-radiation-dose computed tomography (CT) reduced the relative risk for lung cancer death by 20% when compared with chest radiograph screening. The medical community is poised to offer CT screening to patients at risk for lung cancer, and practice guidelines now recommend doing so in a manner that promotes informed patient choice. Well-publicized potential harms of screening, such as fear and injury after false-positive findings, will certainly be part of this discussion. However, what clinicians should tell patients about the magnitude of the benefit is not clear—the 20% relative benefit seen in the NLST is not the most relevant metric of benefit to a person who is considering being screened.
Annals of Internal Medicine , résumé, 2011