OBJECTIVES: There is no established effective lung cancer screening modality. Positron Emission Tomography (PET) is helpful in lung cancer disease extent evaluation. The objective of our study is to evaluate the role of PET in lung cancer screening via systematic review. METHODS: Using a strategy similar to a previous computed tomography (CT) lung cancer screening systematic review [Black et al. Thorax 2007;62:131–138], we searched for primary studies focusing on PET screening for lung cancer using the following keywords “(lung cancer) AND (positron emission tomography) AND ((screen) OR (screening))” in Pubmed® on Nov 30th, 2010. Two reviewers (Chien C.R. & Wang H.N) reviewed all the identified studies independently to find out studies compatible with our inclusion/exclusion criteria. Further discussion with 3rd reviewer (Kao C.H.) was taken to reach conclusion when there was any disagreement among the reviewers. Manual searching for relevant studies was also performed from the included studies. We restricted our analysis to non-overlapped studies published since 2000 and in English. RESULTS: Among the identified studies (n=2733), 239 studies were published before 2000, 2440 studies were excluded due to irrelevant titles and keywords, and another 34 studies were excluded after reviewing the abstracts. Full paper evaluation led to further exclusion of 11 studies, and manual search led to inclusion of 2 additional studies, leaving 11 studies for analysis. No studies evaluated the efficacy of primary PET screening specific for lung cancer. Eight studies focused on primary PET screening for cancer, and three studies reported finding in lung cancer CT screening programs with selective PET. CONCLUSIONS: The role of primary PET screening for lung cancer remains unknown. PET has the potential to be used as a screening modality not specific for lung cancer and as a selective modality in combination with CT for lung cancer screening.  [1] Black et al.  Thorax 2007; 62:131-138