Current evidence of low-dose CT screening benefit

Rowena Yip; James L Mulshine; Matthijs Oudkerk; John Field; Mario Silva; David F Yankelevitz; Claudia I Henschke

doi:10.1016/j.ejca.2025.115570

Current evidence of low-dose CT screening benefit

Eur J Cancer. 2025 Jun 9:225:115570. doi: 10.1016/j.ejca.2025.115570. Online ahead of print.

Authors

Rowena Yip¹, James L Mulshine², Matthijs Oudkerk³, John Field⁴, Mario Silva⁵, David F Yankelevitz¹, Claudia I Henschke⁶

Affiliations

¹ Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
² Department of Internal Medicine, Graduate College, Rush University Medical Center, Chicago, IL, USA.
³ Institute for Diagnostic Accuracy, Groningen, the Netherlands; Faculty of Medical Sciences, University of Groningen, Groningen, the Netherlands.
⁴ Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
⁵ Scienze Radiologische, Department of Medicine and Surgery (DiMeC), Parma, Italy; Department of Radiology, University of Massachusetts Memorial Health, University of Massachusetts, Chan Medical School, Worcester, MA, USA.
⁶ Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: Claudia.henschke@mountsinai.org.

PMID: 40517528
DOI: 10.1016/j.ejca.2025.115570

Abstract

Lung cancer is the leading cause of cancer-related mortality worldwide, largely due to late-stage diagnosis. Low-dose computed tomography (LDCT) screening has emerged as a powerful tool for early detection, enabling diagnosis at curable stages and reducing lung cancer mortality. Despite strong evidence, LDCT screening uptake remains suboptimal globally. This review synthesizes current evidence supporting LDCT screening, highlights ongoing global implementation efforts, and discusses key insights from the 1st AGILE conference. Lung cancer screening is gaining global momentum, with many countries advancing plans for national LDCT programs. Expanding eligibility through risk-based models and targeting high-risk never- and light-smokers are emerging strategies to improve efficiency and equity. Technological advancements, including AI-assisted interpretation and image-based biomarkers, are addressing concerns around false positives, overdiagnosis, and workforce burden. Integrating cardiac and smoking-related disease assessment within LDCT screening offers added preventive health benefits. To maximize global impact, screening strategies must be tailored to local health systems and populations. Efforts should focus on increasing awareness, standardizing protocols, optimizing screening intervals, and strengthening multidisciplinary care pathways. International collaboration and shared infrastructure can accelerate progress and ensure sustainability. LDCT screening represents a cost-effective opportunity to reduce lung cancer mortality and premature deaths.

Keywords: Cardiovascular diseases; Early detection; Lung Cancer; Preventive health; Tobacco-related diseases.

Publication types

Review