Kawahara Masaaki
Department of Internal Medicine, National Kinki Central Hospital for Chest Diseases, 1180 Nagasone, Sakai, Osaka 591-8555, Japan.
Curr Opin Oncol. 2004 Mar;16(2):141-5. doi: 10.1097/00001622-200403000-00010.
With the development of newer forms of technology such as low-dose spiral computed tomography, there has been a resurgent interest in screening for lung cancer. The purpose of this review is to highlight recent advances in screening for lung cancer. Articles published since September 2002 are reviewed here.
More frequent screenings (every 4 or 6 months) showed increased mortality from lung cancer, compared with annual screening. A mass screening conducted in 1990 was effective in a case-control study. The results of lung cancer screening by low-dose spiral computed tomography were reported from the Milan group and the Mayo Clinic. Computed tomography depicted peripheral early lung cancer, especially adenocarcinoma. These results are consistent with previous reports from other groups. Screening with imaging becomes more sensitive with automated computerized methods.
A high percentage of stage IA lung cancers were detected by screening with low-dose helical computed tomography. The characteristics of the nodules detected by low-dose spiral computed tomography have been clarified. There have been many controversial discussions about cost effectiveness and overdiagnosis. There is still no evidence that screening tests reduce the rate of cancer-specific mortality. Several studies of screening for lung cancer are under way.
随着低剂量螺旋计算机断层扫描等新型技术的发展，肺癌筛查再次受到关注。本综述旨在强调肺癌筛查的最新进展。本文回顾了自2002年9月以来发表的文章。
与年度筛查相比，更频繁的筛查（每4或6个月一次）显示肺癌死亡率增加。1990年进行的一项大规模筛查在病例对照研究中是有效的。米兰小组和梅奥诊所报告了低剂量螺旋计算机断层扫描肺癌筛查的结果。计算机断层扫描显示周围型早期肺癌，尤其是腺癌。这些结果与其他小组先前的报告一致。使用自动化计算机方法进行成像筛查会变得更加敏感。
通过低剂量螺旋计算机断层扫描筛查发现了高比例的IA期肺癌。低剂量螺旋计算机断层扫描检测到的结节特征已得到明确。关于成本效益和过度诊断存在许多有争议的讨论。仍然没有证据表明筛查测试能降低癌症特异性死亡率。几项肺癌筛查研究正在进行中。
