Kubík A, Haerting J
Research Institute of Tuberculosis and Respiratory Diseases, Prague, Czechoslovakia.
Neoplasma. 1990;37(4):467-75.
In a randomized prospective study of lung cancer detection in a high-risk population of over 6000 heavy smokers semiannual screening by X-ray and sputum cytology was compared to screening at a 3-year interval. The comparison of Kaplan-Meier estimates of survival curves done without and with correcting for lead-time bias disclosed a rather important impact of lead-time bias on survival comparisons. On the contrary, controlling for possible length bias had no obvious effect on the shape of survival curves. The evaluation of mortality from lung cancer, being used as a basic criterion, indicated no traceable benefit from semiannual screening. The higher incidence of lung cancer in the frequently screened group was paralleled by a higher mortality. It is concluded that currently available screening techniques will not solve the problem of lung cancer mortality in smokers. The results underline the importance of primary prevention for lung cancer.
在一项针对6000多名重度吸烟者的高危人群进行肺癌检测的随机前瞻性研究中，将每半年进行一次X线和痰细胞学筛查与每3年进行一次筛查进行了比较。对生存曲线的Kaplan-Meier估计值在不校正和校正领先时间偏倚的情况下进行比较，结果显示领先时间偏倚对生存比较有相当重要的影响。相反，控制可能的长度偏倚对生存曲线的形状没有明显影响。以肺癌死亡率作为基本标准进行评估，结果表明半年一次的筛查没有可追溯的益处。频繁筛查组中较高的肺癌发病率伴随着较高的死亡率。得出的结论是，目前可用的筛查技术无法解决吸烟者肺癌死亡率的问题。这些结果强调了肺癌一级预防的重要性。
