Strauss G M, Dominioni L
Department of Adult Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
Surg Oncol Clin N Am. 1999 Apr;8(2):371-87.
Although screening for lung cancer is not currently recommended, randomized trials consistently demonstrate that chest x-ray screening is associated with significant advantages in stage distribution, resectability, and long-term survival. Because these advantages have not been accompanied by a reduction in lung cancer mortalities a because an excess number of lung cancers were detected in experimental populations in two studies, it has been suggested that screening leads to the detection of clinically unimportant lung cancers. This hypothesis, known as overdiagnosis, is the only obstacle to the conclusion that chest x-ray screening saves lives. However, abundant evidence convincingly demonstrates that the overdiagnosis hypothesis is myth with regard to chest x-ray screening for lung cancer. With more than one million deaths from lung cancer on a worldwide basis every year, public policy regarding screening for lung cancer is in urgent need of reconsideration.
尽管目前不推荐进行肺癌筛查，但随机试验一致表明，胸部X光筛查在分期分布、可切除性和长期生存方面具有显著优势。由于这些优势并未伴随着肺癌死亡率的降低，且在两项研究的实验人群中检测到过多的肺癌，因此有人认为筛查导致了临床上不重要的肺癌被检测出来。这一假说被称为过度诊断，是得出胸部X光筛查能挽救生命这一结论的唯一障碍。然而，大量证据令人信服地表明，就肺癌的胸部X光筛查而言，过度诊断假说是无稽之谈。每年全球有超过100万人死于肺癌，因此关于肺癌筛查的公共政策急需重新考虑。
