An umbrella review of systematic evidence on the Low Dose Computed Tomography (LDCT) for lung cancer screening

Despite lung cancer’s high mortality rate, many countries still lack organized lung cancer screening programs. This review aims to evaluate the impact of low-dose computed tomography (LDCT) screening on lung cancer diagnosis, mortality, and overall clinical outcomes. Following the Joanna Briggs Institute methodology for umbrella reviews, a comprehensive search was conducted in PubMed, Embase, and the Cochrane Library for reviews published between January 2013 and December 2023. Eligible meta-analyses included studies comparing LDCT screening with chest X-ray (CXR) or no screening, reporting outcomes such as sensitivity, specificity, and lung cancer mortality. The methodological quality of the included reviews was assessed using AMSTAR-2. Out of 801 citations, 14 meta-analyses met the inclusion criteria. LDCT demonstrated high sensitivity (0.97, 95% CI: 0.94–0.98) and specificity (0.87, 95% CI: 0.82–0.91). It significantly increased early-stage lung cancer detection (RR: 1.31, 95% CI: 1.18–1.45) and reduced lung cancer mortality by 18% (RR: 0.82, 95% CI: 0.75–0.90). However, the reduction in all-cause mortality (RR: 0.91, 95% CI: 0.75–1.06) was not statistically significant. Overdiagnosis and false positives remain essential challenges. This umbrella review confirms that LDCT screening effectively reduces lung cancer mortality, particularly in high-risk populations. Lung cancer was the most commonly diagnosed cancer worldwide in 2022, leading to over 2.5 million new cases and 1.8 million deaths. Although lung cancer has a high death rate, many countries still do not have screening programs in place to detect it early. This review examined the effectiveness of a special type of scan, known as low-dose computed tomography (LDCT), in detecting lung cancer early and saving lives. Researchers searched several major medical databases for studies published between 2013 and 2023. They focused on studies that compared LDCT scans with regular chest X-rays or no screening and checked the quality of the studies they included. Out of 801 studies found, 14 high-quality reviews were selected. The results showed that LDCT scans are very good at correctly detecting lung cancer. They helped find cancer earlier and reduced deaths from lung cancer by 18%. There were also concerns about finding cancers that may not have caused problems (overdiagnosis) and false alarms (false positives). In conclusion, LDCT screening can help save lives by detecting lung cancer early, especially in people at high risk, but some challenges need to be carefully managed.