Marcus P M
Division of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892-7354, USA.
J Clin Oncol. 2001 Sep 15;19(18 Suppl):83S-86S.
Two prominent and timely issues in lung cancer screening are discussed in this article. First, findings from extended mortality follow-up of participants enrolled as part of the Mayo Lung Project are reviewed. These findings suggest that overdiagnosis-the identification, through screening, of clinically unimportant lung cancer lesions-may occur when screening for lung cancer. Second, the question of whether sufficient evidence exists to advocate mass lung cancer screening with low radiation dose spiral computed tomography (CT) is discussed. Given the absence of lung cancer mortality data for spiral CT, it is concluded that such activities should not be advocated at this point in time. The Lung Screening Study, an ongoing randomized controlled trial of lung cancer screening with spiral CT, also is described.
本文讨论了肺癌筛查中两个突出且及时的问题。首先，回顾了作为梅奥肺癌项目一部分登记的参与者延长死亡率随访的结果。这些结果表明，在肺癌筛查时可能会出现过度诊断——通过筛查发现临床上无重要意义的肺癌病变。其次，讨论了是否有足够证据支持采用低辐射剂量螺旋计算机断层扫描（CT）进行大规模肺癌筛查的问题。鉴于缺乏螺旋CT的肺癌死亡率数据，得出的结论是目前不应提倡此类活动。还介绍了肺部筛查研究，这是一项正在进行的关于螺旋CT肺癌筛查的随机对照试验。
