Annual number of lung cancer deaths potentially avertable by screening in the United States
Annual number of lung cancer deaths potentially avertable by screening in the United States
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DOI：
10.1002/cncr.27813
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发表时间：
2013-04-01
期刊：
影响因子：
6.2
通讯作者：
Jemal, Ahmedin
中科院分区：
文献类型：
--
作者：
Ma, Jiemin;Ward, Elizabeth M.;Jemal, Ahmedin
背景：2002年至2009年间进行的国家肺部筛查试验（NLST）表明，与胸部x线相比，低剂量计算机断层扫描（LDCT）筛查可使符合筛查条件的人群肺癌死亡率降低20%。在这篇文章中，假设NLST中采用的筛查方案在美国得到全面实施，作者提供了每年可通过筛查避免的肺癌死亡人数的估计。方法:每年可通过筛查避免的肺癌死亡人数被估计为筛查效果、美国人口规模（从2010年美国人口普查数据获得）、筛查资格的流行程度（使用2010年全国健康访谈调查[NHIS]数据估计）、以及符合筛查条件人群的肺癌死亡率（使用2000-2004年国家健康信息系统数据和第三次全国健康与营养检查调查相关死亡率档案进行估算）。分别按性别、年龄和吸烟状况进行分析，使用泊松回归分析估计死亡率。通过模拟量化了可避免肺癌死亡人数估计的不确定性。结果：2010年约有860万美国人（95%置信区间[95% CI]， 800万- 920万）符合肺癌筛查条件，其中包括520万男性（95% CI， 480万- 570万）和340万女性（95% CI， 300万- 380万）。如果NLST中采用的筛查方案在这些符合筛查条件的美国人群中完全实施，每年将避免12,250例（95% CI, 10,170-15,671）肺癌死亡（男性死亡8990例，女性死亡3260例）。结论：当前研究的数据表明，LDCT筛查可以潜在地避免美国每年约12,000例肺癌死亡。需要进一步的研究来估计可避免的肺癌死亡人数和LDCT筛查在不同风险情景、不同筛查频率和不同筛查吸收率下的成本效益。（见本期000000页社论。）2013年癌症。(c) 2012年美国癌症协会。
BACKGROUND: The National Lung Screening Trial (NLST), which was conducted between 2002 and 2009, demonstrated that screening with low-dose computed tomography (LDCT) reduced lung cancer mortality by 20% among screening-eligible populations compared with chest x-ray. In this article, the authors provide an estimate of the annual number of lung cancer deaths that can be averted by screening, assuming the screening regimens adopted in the NLST are fully implemented in the United States. METHODS: The annual number of lung cancer deaths that can be averted by screening was estimated as a product of the screening effect, the US population size (obtained from the 2010 US Census data), the prevalence of screening eligibility (estimated using the 2010 National Health Interview Survey [NHIS] data), and the lung cancer mortality rates among screening-eligible populations (estimated using the NHIS data from 2000-2004 and the third National Health and Nutrition Examination Survey linked mortality files). Analyses were performed separately by sex, age, and smoking status, with Poisson regression analysis used for mortality rate estimation. Uncertainty of the estimates of the number of avertable lung cancer deaths was quantified by simulation. RESULTS: Approximately 8.6 million Americans (95% confidence interval [95% CI], 8.0 million-9.2 million), including 5.2 million men (95% CI, 4.8 million-5.7 million) and 3.4 million women (95% CI, 3.0 million -3.8 million), were eligible for lung cancer screening in 2010. If the screening regimen adopted in the NLST was fully implemented among these screening-eligible US populations, a total of 12,250 (95% CI, 10,170-15,671) lung cancer deaths (8990 deaths in men and 3260 deaths in women) would be averted each year. CONCLUSIONS: The data from the current study indicate that LDCT screening could potentially avert approximately 12,000 lung cancer deaths per year in the United States. Further studies are needed to estimate the number of avertable lung cancer deaths and the cost-effectiveness of LDCT screening under different scenarios of risk, various screening frequencies, and various screening uptake rates. (See editorial on pages 000000, this issue.) Cancer 2013. (c) 2012 American Cancer Society.