Prospects for population screening and diagnosis of lung cancer
Prospects for population screening and diagnosis of lung cancer
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DOI：
10.1016/s0140-6736(13)61614-1
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发表时间：
2013-08-24
期刊：
影响因子：
168.9
通讯作者：
Duffy, Stephen W.
中科院分区：
文献类型：
--
作者：
Field, John K.;Oudkerk, Matthijs;Duffy, Stephen W.
肺癌死亡人数超过任何其他类型的恶性肿瘤，2010年死亡人数为150万人。预防和戒烟仍然是减少死亡人数的主要方法。美国国家肺部筛查试验将 CT 筛查与胸部 X 光检查进行比较，结果显示 CT 组参与者的死亡率优势为 20%。关于是否存在足够的证据来实施 CT 筛查计划的国际争论仍在继续。当有关有效性和成本效益的问题得到解答后，我们将讨论需要考虑的主要主题，这将等待欧洲最大的试验 NELSON 的发布以及欧洲 CT 筛查试验的汇总分析。这些未解决的问题是风险预测模型，用于识别患者进行 CT 筛查；对不确定结节使用体积分析的放射学方案； CT 识别结节的手术切除方案；筛查间隔；和筛选的持续时间。我们建议开展为期四年、每两年一次的筛查示范项目。
Deaths from lung cancer exceed those from any other type of malignancy, with 1.5 million deaths in 2010. Prevention and smoking cessation are still the main methods to reduce the death toll. The US National Lung Screening Trial, which compared CT screening with chest radiograph, yielded a mortality advantage of 20% to participants in the CT group. International debate is ongoing about whether sufficient evidence exists to implement CT screening programmes. When questions about effectiveness and cost-effectiveness have been answered, which will await publication of the largest European trial, NELSON, and pooled analysis of European CT screening trials, we discuss the main topics that will need consideration. These unresolved issues are risk prediction models to identify patients for CT screening; radiological protocols that use volumetric analysis for indeterminate nodules; options for surgical resection of CT-identified nodules; screening interval; and duration of screening. We suggest that a demonstration project of biennial screening over a 4-year period should be undertaken.