A review of lung cancer screening and the role of computer-aided detection

Lung cancer is the leading cause of cancer-related death worldwide; however, early diagnosis of lung cancer leads to higher survival rates. The National Lung Screening Trial (NLST) demonstrated that scanning with low-dose computed tomography (LDCT) led to a 20% reduction in mortality rate in a high-risk population. This paper covers new developments in screening eligibility criteria and the possible benefits and the harm of screening with CT. To make the screening process more feasible and help reduce the rate of missed lung nodules, computer-aided detection (CAD) has been introduced to assist radiologists in lung nodule detection. The aim of this paper is to review how CAD works, its performance in lung nodule detection, and the factors that influence its performance. This paper also aims to investigate the effect of different types of CAD on CT in lung nodule detection and the effect of CAD on radiologists' decision outcomes. (C) 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.