COUNTERPOINT: Should Only Primary Care Physicians Provide Shared Decision-making Services to Discuss the Risks/Benefits of a Low-Dose Chest CT Scan for Lung Cancer Screening? No

The National Lung Screening Trial, the largest randomized controlled lung cancer screening study ever performed, showed a 20% relative decrease in lung cancer mortality and a 7% decrease in overall mortality in high-risk individuals who were screened with LDCT scanning of the chest vs those screened with chest radiographs.1,2 LDCT screening may cause harm, an important concern given that most individuals undergoing screening do not have cancer and therefore cannot benefit from screening. Moreover, LDCT screening is a complex process requiring careful coordination. The process begins with selecting appropriate candidates for screening and discussing screening tradeoffs with patients, includes annual screening LDCT scans, and extends through evaluation of suspicious findings and treatment of screen-detected cancers.

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