Lung Cancer Screening.

Lung Cancer Screening.
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DOI:
10.1016/j.mcna.2017.03.008
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发表时间:
2017-07
期刊:
The Medical clinics of North America
影响因子:
--
通讯作者:
Sanchez R
Sanchez R
中科院分区:
其他
文献类型:
--
作者:
Hoffman RM;Sanchez R

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肺癌是美国第二大最常见的癌症,也是癌症死亡的主要原因。2016年,预计将有224,390例新的肺癌病例沿着158,080例肺癌相关死亡。这些死亡中有80%以上是由于烟草暴露,使初级预防成为最有效的癌症控制策略。2虽然早期肺癌的5年生存率超过50%,但大多数癌症是在晚期发现的,此时生存率很低。3因此,筛查已被提议作为降低肺癌死亡率的策略。对照试验显示胸部X线摄影和痰细胞学检查是无效的筛查测试,但低剂量计算机断层扫描(LDCT)筛查可以显着降低肺癌死亡率。5本综述将重点介绍LDCT筛查试验,特别是国家肺筛查试验(NLST),随后发布的筛查指南,以及在社区实践中实施筛查计划的挑战和策略。本文首先简要讨论了肺癌的临床表现、病理学、分期、治疗方案、生存率和一级预防策略。
Lung cancer is the 2nd most frequently diagnosed cancer in the United States and the leading cause of cancer death. In 2016, 224,390 new lung cancer cases were expected along with 158,080 lung cancer-related deaths. 1 Over 80% of these deaths are attributable to tobacco exposure making primary prevention the most effective cancer control strategy. 2 While the 5-year survival for early-stage lung cancers exceeds 50%, most cancers are detected at advanced stage when survival is poor. 3 Consequently, screening has been proposed as a strategy for reducing lung cancer mortality. Controlled trials have shown chest radiography and sputum cytology to be ineffective screening tests, 4 but screening with low-dose computed tomography (LDCT) can significantly reduce lung cancer mortality. 5This review will focus on the LDCT screening trials, particularly the National Lung Screening Trial (NLST), the subsequently issued screening guidelines, and challenges and strategies for implementing screening programs in community practice. The review begins by briefly discussing the clinical presentation, pathology, staging, treatment options, survival, and primary prevention strategies for lung cancer.
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