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Lung cancer screening — MCCQE Part 1 MCQ

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ModeratePreventive MedicineLung cancer screeningMCCQE Part 1

62-year-old current smoker presents with asking about cancer screening. He has a 40 pack-year history and is willing to undergo treatment if cancer is found. Which of the following is the most appropriate next step?

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Correct answer: C — Offer referral for low-dose CT screening through an organised programme if eligible

Offer referral for low-dose CT screening through an organised programme if eligible is best because high-risk smokers may benefit from organised LDCT screening. Use a United States screening schedule instead of Canadian guidance is suboptimal because MCCQE questions expect Canadian preventive-care guidance; Defer all preventive care until symptoms develop is suboptimal because screening and immunisation aim to prevent disease before symptoms; Order the most invasive test as routine first-line screening is suboptimal because screening should balance benefit, harm and resource use; Screen at every visit regardless of interval or prior results is suboptimal because over-screening causes avoidable false positives and harm. Screening should occur in structured programmes, not ad hoc CXR.

Reference: Canadian Task Force lung cancer screening guideline