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Population screening does not reduce late stage presentation Cancer overdiagnosisthe diagnosis of cancers that would otherwise not become clinically evidentis inferred from either long term follow-up of randomised trials of screening or patterns in population based cancer statistics.22 Lung cancer overdiagnosis was first documented in the extended follow-up of a randomised trial of chest radiography screening in people who smoke heavily.2324 In the US National Lung Screening Trial (NLST), which recruited over 50 000 participants, CT screening was found to cause more overdiagnosis than chest radiography.25 Although no randomised trials have been conducted of lung cancer screening in never smokers, the effect of screening can be inferred from patterns in incidence of stage specific lung cancer

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