A systematic review of evidence on the benefits and harms of low-dose computed tomography (LDCT) screening for lung cancer was conducted by a multi-society collaborative initiative. The review aimed to develop an evidence-based clinical guideline. Of 591 citations, eight randomized controlled trials (RCTs) and 13 cohort studies met inclusion criteria. The primary outcomes were lung cancer mortality and all-cause mortality, with secondary outcomes including nodule detection, invasive procedures, follow-up tests, and smoking cessation. The National Lung Screening Trial (NLST) found that LDCT screening significantly reduced lung cancer mortality compared to chest X-ray (CXR), with a 20% relative risk reduction. However, two smaller RCTs showed no benefit. LDCT screening resulted in a 20% relative reduction in lung cancer deaths, with an absolute risk reduction of 0.33%. The study also found that about 20% of individuals had positive results requiring follow-up, while approximately 1% had lung cancer. There was marked heterogeneity in follow-up investigations, biopsies, and surgical procedures. LDCT screening may benefit individuals at elevated risk for lung cancer, but uncertainty exists about potential harms and the generalizability of results. The review identified potential harms, including the detection of benign nodules, which can lead to further imaging and invasive procedures. The frequency of major complications was low, but there was a risk of radiation exposure, with an estimated effective dose of 1.5 mSv per examination. The review also noted that the benefits of LDCT screening may be less favorable for younger individuals or those with lower risk of developing lung cancer. The review concluded that LDCT screening can lead to harm, including the detection of benign nodules and the potential for overdiagnosis. The impact of LDCT screening on quality of life was unclear, with some studies reporting psychological distress in participants awaiting results. The review also highlighted the need for careful implementation of LDCT screening, as the results may vary depending on the setting and the population studied. The review emphasized the importance of considering the cost-effectiveness of LDCT screening, particularly in light of rising healthcare costs. The review also noted that the benefits of LDCT screening may be less favorable for individuals at lower risk of lung cancer, as more individuals would need to be screened to prevent each death. The review concluded that LDCT screening should be implemented in a structured and organized manner to ensure the best outcomes for patients.A systematic review of evidence on the benefits and harms of low-dose computed tomography (LDCT) screening for lung cancer was conducted by a multi-society collaborative initiative. The review aimed to develop an evidence-based clinical guideline. Of 591 citations, eight randomized controlled trials (RCTs) and 13 cohort studies met inclusion criteria. The primary outcomes were lung cancer mortality and all-cause mortality, with secondary outcomes including nodule detection, invasive procedures, follow-up tests, and smoking cessation. The National Lung Screening Trial (NLST) found that LDCT screening significantly reduced lung cancer mortality compared to chest X-ray (CXR), with a 20% relative risk reduction. However, two smaller RCTs showed no benefit. LDCT screening resulted in a 20% relative reduction in lung cancer deaths, with an absolute risk reduction of 0.33%. The study also found that about 20% of individuals had positive results requiring follow-up, while approximately 1% had lung cancer. There was marked heterogeneity in follow-up investigations, biopsies, and surgical procedures. LDCT screening may benefit individuals at elevated risk for lung cancer, but uncertainty exists about potential harms and the generalizability of results. The review identified potential harms, including the detection of benign nodules, which can lead to further imaging and invasive procedures. The frequency of major complications was low, but there was a risk of radiation exposure, with an estimated effective dose of 1.5 mSv per examination. The review also noted that the benefits of LDCT screening may be less favorable for younger individuals or those with lower risk of developing lung cancer. The review concluded that LDCT screening can lead to harm, including the detection of benign nodules and the potential for overdiagnosis. The impact of LDCT screening on quality of life was unclear, with some studies reporting psychological distress in participants awaiting results. The review also highlighted the need for careful implementation of LDCT screening, as the results may vary depending on the setting and the population studied. The review emphasized the importance of considering the cost-effectiveness of LDCT screening, particularly in light of rising healthcare costs. The review also noted that the benefits of LDCT screening may be less favorable for individuals at lower risk of lung cancer, as more individuals would need to be screened to prevent each death. The review concluded that LDCT screening should be implemented in a structured and organized manner to ensure the best outcomes for patients.