Lung cancer is the leading cause of cancer death in the United States. In December 2013, based mainly on the results of the National Lung Screening Trial (NLST) (1), the U.S. Preventive Services Task Force issued a grade B recommendation for lung cancer screening with low-dose CT for those at high risk (2). Shortly thereafter, in February 2015, the Centers for Medicare and Medicaid Services issued a national coverage determination for Medicare coverage conditional on several requirements, including structured reporting of screening results and submission of relevant data to a national registry. However, several important questions about the implementation of lung cancer screening remain.
William C. Black, MD, is a Professor of Radiology and Community and Family Medicine at Dartmouth Hitchcock Medical Center (DHMC) and member of The Dartmouth Institute. His clinical area of expertise is chest radiology and he has research interests in screening, incidental detection and over diagnosis. As the site Principal Investigator at DHMC and a member of the Executive Committee, Dr. Black played a major role in the design, execution, and analysis of the National Lung Screening Trial (NLST). He led the cost-effectiveness analysis related to lung cancer screening in the NLST and was a consultant to the Lung Group of the Cancer Intervention and Surveillance Network (CISNET), which modeled the effects of alternative strategies of lung cancer screening on the US population for the US Preventive Services Task Force. Dr. Black currently serves on several American College of Radiology committees related to lung cancer screening and incidental detection and leads the lung cancer screening program at DHMC.