The frequency of follow-up imaging, surgical biopsy, etc. was analyzed for the detected nodules. Lung cancer is the most lethal neoplastic disease. Most lung cancer patients are not diagnosed until late stages, which results in a very low 5-year survival rate for these patients. Screening may be able to reduce lung cancer mortality. To systematically evaluate the pros and cons of low-dose computed tomography (LDCT) screening for lung cancer, a collaborative effort of societies (including the American Cancer Society, American College of Chest Physicians, American Society of Clinical Oncology, and National Comprehensive Oncology Network) created a grant to develop evidence-based clinical practice guidelines. Their study shows that low-dose computed tomography may benefit potential patients at higher risk for lung cancer, but uncertainty remains. The paper was published in the latest online edition of the prestigious international journal JAMA 2012, with corresponding author Peter B. Bach, MD, of Memorial Sloan-Kettering Cancer Center. Data for this study were obtained from MEDLINE (Ovid: January 1996 to April 2012), EMBASE (Ovid: January 1996 to April 2012), and the Cochrane Library (April 2012). Studies included 591 authenticated or reviewed citations on LDCT screening that met the criteria, 8 randomized trials and 13 cohort studies. The primary endpoint observations of the trial were lung cancer mortality and all-factor mortality, and secondary endpoint observations included nodal detection rate, invasive progression, follow-up examination results, and tobacco cessation rate. The trial performed a critical appraisal of evidence based on individual and aggregate studies, and data differences from the review were adopted only after consensus was reached. Three randomized studies provided evidence on the impact of LDCT screening on lung cancer mortality, with the National Lung Screening Trial study being the most informative, including 53 454 subjects, and showing significant reductions in the number of lung cancer deaths (356 vs 443 overall and 274 vs 309 lung cancer-specific deaths per 100,000 person-years in the LDCT and control groups, respectively). 000 person-years; relative risk value, 0.80; 95% CI, 0.73-0.93; percent absolute risk reduction, 0.33%; P = .004). Two other, smaller studies did not show such a large benefit. For the potential downside of LDCT, combining all trials and cohorts, approximately 20% of individuals with positive screening tests required some level of follow-up each round, and approximately 1% of individuals were diagnosed with lung cancer. This finding, as well as the frequency of follow-up surveys and biopsies in patients with benign lesions, and the rate of surgery, are characterized by significant heterogeneity. Major complications in the benign condition were rare. The researchers thus concluded that low-dose computed tomography may benefit potential patients at higher risk for lung cancer, but there is uncertainty about the drawbacks of screening and the generalizability of the results.