Medical School for International Health, Ben-Gurion University of Negev in collaboration with Columbia University Medical Center, Beer-Sheva, Israel.
Eur J Intern Med. 2010 Feb;21(1):6-11. doi: 10.1016/j.ejim.2009.10.004. Epub 2009 Nov 24.
Lung cancer is the most lethal cancer and most cases are the result of cigarette smoking. Although a high risk target population for screening can be defined, and although early stage lung cancer has a much better prognosis than advanced disease, there is still no clear evidence that lung cancer screening decreases mortality. Accordingly, current guidelines suggest that there is no evidence to support routine screening. Although randomized studies in the 1970('s) which used chest x-ray and sputum for screening were clearly negative in the last 20 years more sensitive screening tools such as chest computed tomography have revolutionized the field. However, randomized controlled trials of computed tomography have only recently been launched. AIMS OF THIS REVIEW: Our objectives are to provide the reader with the rationale for screening for lung cancer, to review the older screening studies and their limitations, and to summarize the current knowledge and ongoing trials of lung cancer screening.
A literature search using Medline was conducted from 1966 onwards searching for articles with relevant key words such as lung cancer screening chest X - ray low dose computerized tomography cancer screening guideline. When appropriate additional references were found from the bibliographies of identified papers of interest.
Recent uncontrolled multicenter studies of chest computed tomography scans show encouraging results. However, until data from, large properly designed and appropriately analyzed randomized controlled trials which may overcome research biases is available, the benefit of lung cancer screening, if any is still unknown.
肺癌是最致命的癌症，大多数病例是吸烟的结果。虽然可以定义一个高风险的筛查目标人群，但早期肺癌的预后比晚期疾病要好得多，但仍没有明确的证据表明肺癌筛查可以降低死亡率。因此，目前的指南建议没有证据支持常规筛查。尽管 20 世纪 70 年代（年代）使用胸部 X 线和痰液进行筛查的随机研究在过去 20 年中明显呈阴性，但更敏感的筛查工具如胸部计算机断层扫描（CT）已彻底改变了这一领域。然而，直到最近才开始进行 CT 计算机断层扫描的随机对照试验。
我们的目标是为读者提供肺癌筛查的基本原理，回顾早期的筛查研究及其局限性，并总结当前肺癌筛查的知识和正在进行的试验。
使用 Medline 进行了文献检索，从 1966 年开始搜索带有相关关键词的文章，如肺癌筛查、胸部 X 射线、低剂量计算机断层扫描、癌症筛查指南。在适当时，还从感兴趣的已确定论文的参考文献中找到了其他参考文献。
最近的多中心胸部 CT 扫描非对照研究显示出令人鼓舞的结果。然而，在有适当设计和分析的大型随机对照试验的数据可用之前，可能克服研究偏倚的数据，如果有的话，肺癌筛查的益处仍然未知。
