Extrapulmonary Cancers in Lung Cancer Screening
Menée aux Etats-Unis à partir des données de 75 104 sessions de dépistage par tomographies numériques à faible dose de rayonnement (26 445 participants ; âge moyen : 61,4 ans ; 59 % d'hommes), cette étude évalue l'incidence des cancers extrapulmonaires dans l'année qui suit la session de dépistage puis évalue l'association entre la détection fortuite d'anomalies potentiellement cancéreuses lors du dépistage et le diagnostic de cancer extrapulmonaire
Low-dose computed tomography (LDCT) screening for lung cancer reduces lung cancer–specific mortality and has been accepted as a standard of care in countries around the world. While LDCT screening seeks to identify early lung cancers, the cross-sectional imaging can extend from the neck to upper abdomen, meaning that incidental findings are frequent. What, then, is the responsible use of information that nobody asked for?Most prevalent are incidental findings that, while of potential clinical significance, are nonmalignant, including coronary artery calcification and pulmonary parenchymal changes such as emphysema or interstitial lung abnormalities. Given their prevalence, recommendations for the reporting and onward management of such findings have been developed for screening programs. While the clinical benefit (or otherwise) of flagging such incidental findings remains to be determined, such an approach allows standardization and appropriate management of potential findings at a level acceptable to patients and the wider health care system.
JAMA Network Open , éditorial en libre accès, 2026