For an asymptomatic 60 year-old female with a significant smoking history, what screening do you recommend?

In the context of screening for lung cancer in an asymptomatic 60-year-old female with a significant smoking history, the most appropriate recommendation is to conduct a low-dose helical computed tomography (CT) scan. This screening method has been shown to reduce lung cancer mortality in high-risk populations, such as those with a significant smoking history.

The rationale behind low-dose CT screening is based on studies, including the National Lung Screening Trial, which demonstrated that this method can detect lung cancer at an earlier stage compared to traditional chest radiographs, leading to improved outcomes. The use of CT is particularly encouraged for individuals aged 50 and older who have a 20-pack-year smoking history and are either current smokers or have quit within the past 15 years.

While referring a patient for smoking cessation is indeed an important aspect of overall health management, particularly for someone with a significant smoking history, it is not the only consideration when addressing screening for lung cancer. The focus should be on appropriate screening methods that have proven efficacy in reducing morbidity and mortality from lung cancer within the high-risk group.

Screening methods like carcinoembryonic antigen (CEA) testing and serial chest radiographs are less effective for the specific purpose of early lung cancer detection. CEA can