POINT: Should Lung Cancer Screening Be Expanded to Persons Who Don’t Currently Meet Accepted Criteria Set Forth by the CHEST Guidelines on Lung Cancer Screening? Yes

Chest: The Journal of Circulation, Respiration and Related Systems

Douglas E. Wood¹ 

关键词: CHEST;    American College of Chest Physicians;    LDCT;    low-dose CT;    NCCN;    National Comprehensive Cancer Network;    NLST;    National Lung Screening Trial;   

DOI  :  10.1016/j.chest.2018.03.017

学科分类：呼吸医学

来源: American College of Chest Physicians

【 摘 要 】

Figures Figure 1 OR of lung cancer in individuals with emphysema. Results from a pooled analysis of emphysema as a risk factor for the development of lung cancer, International Lung Cancer Consortium, 1984-2011. The graph shows a forest plot of the association between emphysema and lung cancer risk by study center, smoking status, and histologic type. Models adjusted for age, sex, and pack-years of smoking. P values are from a test for heterogeneity across studies or across subgroups. “With removals” represents removal of the Mayo, Central Europe, HMGU, WSU/KCI-2, and UCLA studies. See Table 1 for published references. CREST = CREST (Cancer of the Respiratory Tract) Biorepository; Danish, Danish Diet, Cancer, and Health Study; HMGU = Helmholtz Center Munich; KCI = Karmanos Cancer Institute; Liverpool = Liverpool Lung Project; NCI = National Cancer Institute; NELCS = New England Lung Cancer Study; New York = New York Multicenter Study; RR = relative risk; SCC = squamous cell carcinoma; SCLC = small cell lung cancer; Toronto = Samuel Lunenfeld Research Institute; UCLA = University of California, Los Angeles; UCSF = University of California, San Francisco; WSU = Wayne State University; WSU/KCI-1 = Family Health Study; WSU/KCI-2 = study of women's lung cancer epidemiology. Figure 2 A, Representative overall lung cancer survival curve. (Reprinted from Parente Lamelas et al,¹⁵Copyright (2014), with permission from Elsevier.) B, Lung cancer survival in screened detected lung cancer in the International Early Lung Cancer Action Project (I-ELCAP). The identification of a 20% lung cancer mortality reduction attributable to annual screening with low-dose CT imaging¹ is the most profound advance in the war against cancer in a generation. The relatively simple but powerful impact of early detection in lung cancer has the potential to save 12,000 to 15,000 lives per year in the United States alone.^2,3 No other cancer intervention or therapy comes close to this impact of converting cancer victims to cancer survivors.

【 授权许可】

CC BY