Screening for lung cancer: Current status and future directions - Thomas A. Neff lecture
Screening for lung cancer: Current status and future directions - Thomas A. Neff lecture
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DOI：
10.1378/chest.125.5_suppl.158s
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发表时间：
2004-05-01
期刊：
影响因子：
9.6
通讯作者：
Midthun, DE
中科院分区：
文献类型：
--
作者：
Jett, JR;Midthun, DE
肺癌是北美第一大癌症杀手。目前，不建议进行肺癌筛查。因此，患者只有出现症状性疾病（通常是疾病晚期）才会得到诊断。之前的胸部X线检查和痰细胞学筛查试验未能显示肺癌死亡率下降。一些低剂量螺旋 CT 扫描筛查报告发现，肺癌的尺寸（平均尺寸，1.5 厘米）比通常通过胸部 X 光检查（平均尺寸，3.0 厘米）检测到的肺癌尺寸要小。螺旋 CT 扫描已被证明可以检测出 58% 至 85% 的 IA 期非小细胞肺癌 (NSCLC)，这与当前的医疗实践相比是有利的，目前的医疗实践中只有 15% 被检测为局部疾病（监测、流行病学和最终结果研究数据）。本文总结了螺旋CT筛查数据，并回顾了痰细胞学、痰甲基化和自发荧光支气管镜筛查相关的一些数据。最后，简要讨论了一些有前途的未来策略，重点介绍了本次阿斯彭肺病会议上提出的研究数据。
Lung cancer is the number one cancer killer in North America. Currently, screening for lung cancer is not recommended. Therefore, patients will not receive a diagnosis until they present with symptomatic disease, which is usually advanced stage disease. Previous trials of screening with chest roentgenograms and sputum cytology have failed to show a decrease in lung cancer mortality. Some reports of screening with low-dose spiral CT scans have detected lung cancers at a smaller size (average size, 1.5 cm) than those usually detected by chest radiographs (mean size, 3.0 cm). Spiral CT scanning has been shown to detect between 58% and 85% of non-small cell lung cancers (NSCLCs) while they are in stage IA, and this compares favorably to the current medical practice, in which only 15% are detected as localized disease (Surveillance, Epidemiology, and End Results study data). This article summarizes the spiral CT screening data, and reviews some of the data related to screening with sputum cytology, sputum methylation, and autofluorescence bronchoscopy. Last, there is a brief discussion of some promising future strategies, with emphasis and data from studies presented at this Aspen Lung Conference.