Is our natural-history model of lung cancer wrong?
Is our natural-history model of lung cancer wrong?
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DOI：
10.1016/s1470-2045(08)70176-1
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发表时间：
2008-07-01
期刊：
影响因子：
51.1
通讯作者：
Bach, Peter B.
中科院分区：
文献类型：
--
作者：
Bach, Peter B.
为使筛查在肺癌中取得成功，规划需要确定可高度治疗的致命疾病的前兆。这种前体目前被认为是早期肺癌，因此我们目前在肺癌筛查方面的努力主要集中在发现和治疗早期肺癌。换句话说，我们目前的肺癌自然历史模型是基于这样一种观念，即在肺癌变得晚期和致命之前的一段时间里，它是局部的，是可以治疗的。来自肺癌筛查研究的实证结果表明，这种观念是不正确的。这些研究都表明，通过筛查发现的早期组织学证实的肺癌并不是晚期或不治之症的前兆。如果这是真的，这些发现对开发和评估新的肺癌筛查方法具有潜在的重要意义。
For screening to be successful in lung cancer, programmes need to identify a precursor of fatal disease that is highly treatable. This precursor is currently presumed to be early-stage lung cancer, and thus our current efforts in lung-cancer screening have focused on finding, and treating, early-stage lung cancer. In other words, our current natural-history model of lung cancer is based on the notion that for a period before a lung cancer becomes advanced and fatal, it is localised and treatable. Empirical findings emerging from studies of lung-cancer screening suggest this notion to be incorrect. These studies all suggest that early-stage histologically confirmed lung cancers identified by screening are not precursors of advanced or incurable disease. If true, these findings have potentially important implications for the development and assessment of new lung-cancer screening approaches.