Rosh Internal Medicine Boost Practice Exam

Which lung cancer screening method is recommended for a current smoker with a significant smoking history?

1. Chest radiography

2. Low-dose chest computed tomography

3. Positron emission tomography

4. Sputum cytology

The correct answer is: Low-dose chest computed tomography

The recommended lung cancer screening method for a current smoker with a significant smoking history is low-dose chest computed tomography (CT). This method is favored due to its ability to detect lung cancer at an earlier stage compared to other screening modalities. Low-dose CT scans use a lower amount of radiation than standard CT scans and have been shown to reduce lung cancer mortality in high-risk populations, particularly those aged 55 to 80 years with a history of heavy smoking. It is more sensitive in identifying small nodules and early-stage cancers, which is crucial for improving survival rates. In contrast, chest radiography, while historically used for lung cancer screening, has not demonstrated a significant reduction in mortality from lung cancer when used alone. Positron emission tomography (PET) is typically used for staging and evaluating known lung cancers rather than for screening asymptomatic individuals. Sputum cytology has limited sensitivity and specificity for early detection of lung tumors, making it less effective as a screening tool. Thus, low-dose chest CT is clearly the most appropriate option for lung cancer screening in this context.