In an article in Annals of Internal Medicine (link below), a case study is presented which illustrates the difficulties in deciding who may benefit from LDCT (low dose ct scan chest) for lung cancer screening. The take home message is that even with people who meet the criteria for screening (ages 55-75 with greater than 30 pack years of tobacco smoking within 15 years of quitting), risk stratification and shared decision making should occur. Risk stratification is described as using clinical characteristics to stratify who of the above people are at highest risk for lung cancer as screening did not benefit everyone with the above criteria equally. Shared decision making is presenting all data to the particular patient and letting them then decide what they want to do within the context of their health histories and existing co-morbidities.
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