Artinian Vasken, Kvale Paul A
Henry Ford Hospital, Division of Pulmonary and Critical Care, Detroit, MI 48202, USA.
Respirology. 2005 Nov;10(5):558-66. doi: 10.1111/j.1440-1843.2005.00750.x.
In the USA, lung cancer is the leading cause of cancer death. Earlier studies of CXR and sputum cytology screening conducted in the 1970s showed no mortality benefit. Accordingly, mass screening for lung cancer was abandoned and is not currently recommended. Recently, interest in lung cancer screening has been revived due to various reports showing an advantage of low-dose CT over CXR in detecting smaller size tumours and at an earlier stage. Although these reports generated much enthusiasm for screening among clinicians and the general public, the effectiveness of low-dose CT in reducing lung cancer-specific mortality rates has not been demonstrated. Large-scale randomized controlled trials are currently in progress to determine the efficacy of CXR and low-dose CT screening. This review highlights the advantages and limitations of current modalities for lung cancer screening. The cases for and against screening with currently available modalities are examined. Additional new screening modalities are also discussed.
在美国，肺癌是癌症死亡的主要原因。20世纪70年代对胸部X光（CXR）和痰细胞学筛查进行的早期研究显示，并无降低死亡率的益处。因此，肺癌大规模筛查被放弃，目前也不推荐进行。最近，由于各种报告显示低剂量CT在检测较小尺寸肿瘤和早期肿瘤方面优于胸部X光，人们对肺癌筛查的兴趣再度燃起。尽管这些报告在临床医生和普通公众中引发了对筛查的极大热情，但低剂量CT在降低肺癌特异性死亡率方面的有效性尚未得到证实。目前正在进行大规模随机对照试验，以确定胸部X光和低剂量CT筛查的效果。本综述重点介绍了当前肺癌筛查方式的优点和局限性。探讨了支持和反对使用现有方式进行筛查的理由。还讨论了其他新的筛查方式。
