Which is the current guideline for lung cancer screening in high-risk individuals?

• A. Annual CXR starting at age 55
• B. Annual CT starting at age 55
• C. Annual CXR + CEA starting at age 55
• D. No screening is recommended if asymptomatic

Answer: (B)

The main idea is that lung cancer screening in people at high risk is done with an annual low-dose CT scan, not chest X-ray or tumor markers, because CT detects cancers earlier and reduces mortality more effectively.

This option fits best because it specifies the test (annual low-dose CT) and the starting point (around mid-50s) for those with substantial smoking history, aligning with the population most likely to benefit from screening. Chest X-ray has not been shown to reduce lung-cancer deaths, so it’s not recommended as a screening tool. Using a tumor marker like CEA isn’t appropriate for screening due to poor accuracy, and simply not screening asymptomatic individuals would miss opportunities to detect cancers early in high-risk patients.