Development and update of lung cancer screening guideline based on evaluation of efficacy

In order to reduce cancer mortality by screening, it is first necessary, to evaluate the efficacy of cancer screening in terms of mortality reduction based on scientific evidence (cancer screening assessment), then to properly implement the screening for which efficacy has been already established (cancer screening management). The Japanese Research Group for Development of Cancer Screening Guidelines supported by Grand-in-Aid for Cancer Research from the Japanese Ministry of Health, Labour and Welfare fixed a standard procedure to develop cancer screening guidelines and updated the guideline for lung cancer according to this procedure. The group evaluated that "Chest X-ray for the non-high-risk group and chest X-ray combined with sputum cytology for high-risk group" was 2+ (moderate-quality case-control or cohort studies evaluating mortality reduction) as a level of evidence and B (fair evidence to recommend the service) for a level of recommendation. For "Low-dose CT", it is evaluated to be 2 - (poor-quality case-control or cohort studies evaluating mortality reduction) and I (insufficient evidence to recommend for or against), respectively.