Your cancer, your life - screening for lung cancer (repeating every three or four months)

YOUR CANCER, YOUR LIFE - SCREENING FOR LUNG CANCER (REPEATING EVERY THREE OR FOUR MONTHS)
How about X-rays for screening then? These are not completely safe, especially if we consider repeating them every three or four months for years on end. They are simple and convenient but not cheap. False negatives can occur if the cancer is small or situated close to the heart and major blood vessels, making it hard to see. False positives are more common than with cytology, as a number of other conditions can produce similar shadows. Additional tests would be needed to confirm the diagnosis. The smallest cancer we could hope to see would be about a centimetre across, often they would be bigger. The chance of completely curing these cancers by surgical removal is not so good, as some will already have spread.
Bronchoscopy is so expensive, inconvenient and uncomfortable that it couldn't really be considered as a screening test for large numbers of patients. Remember that it would have to be repeated every few months if we wanted to get all the cancers early. Cancers in the small bronchial tubes or in large ones but not ulcerating through the lining would be missed—those false negatives again. False positives are rare. This test can pick up cancers at a stage where they are surgically curable, but some would already have spread.
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Cancer
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