For lung cancer screening in a 65-year-old man with a significant smoking history, which method is recommended?

Low-dose chest computed tomography (CT) is the recommended method for lung cancer screening in individuals at high risk, such as a 65-year-old man with a significant smoking history. This recommendation is based on evidence showing that low-dose CT effectively detects lung cancer at an earlier stage than other imaging modalities.

The low-dose CT scan has a higher sensitivity for identifying lung nodules compared to standard chest radiography. This increased sensitivity allows for the detection of smaller tumors that may not yet be symptomatic, thereby improving the chances of early intervention and better outcomes.

The use of low-dose CT for screening is also supported by guidelines from major health organizations such as the U.S. Preventive Services Task Force (USPSTF), which endorse screening for lung cancer in adults aged 50 to 80 years with a history of heavy smoking.

While other methods, such as chest radiography and sputum cytology, have historically been used for lung cancer detection, they are not recommended for routine screening due to their lower sensitivity and specificity. Positron emission tomography (PET) is typically utilized for staging or evaluating known lung cancer rather than for initial screening, as it does not serve the purpose of identifying early disease in asymptomatic individuals.