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Lung Cancer Screening — SCE Medical Oncology MCQ

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HardLung CancerLung Cancer ScreeningSCE Medical Oncology

A 64-year-old former smoker accepts an NHS Lung Cancer Screening Programme lung health check. She has no lung-cancer symptoms. PLCOm2012 estimates a 1.6% six-year risk and LLPv2 estimates a 2.1% five-year risk. What is the screening decision?

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Correct answer: E — Offer low-dose CT because the PLCOm2012 value exceeds the 1.51% six-year programme threshold

Explanation lettering: E = shown as D · D = shown as E

D is correct. After age and smoking-history eligibility, the English programme offers LDCT when either accepted risk threshold is met: PLCOm2012 at least 1.51% over six years or LLPv2 at least 2.5% over five years. Her PLCOm2012 result qualifies even though LLPv2 does not. The pathway includes former smokers, uses non-contrast low-dose CT rather than diagnostic contrast CT, and does not use PET-CT as a screening test. Symptoms suggestive of lung cancer would instead require diagnostic referral and should not be channelled through screening.

Reference: NHS England Lung Cancer Screening Programme standard protocol: https://www.england.nhs.uk/publication/targeted-screening-for-lung-cancer/