Department of Medicine, Division of Respiratory Medicine, University of British Columbia, BC, Canada.
Department of Medicine, Division of Respiratory Medicine, University of British Columbia, BC, Canada; Imaging Unit, Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada.
Chest. 2012 May;141(5):1147-1152. doi: 10.1378/chest.11-1863.
Lung cancer is the leading cause of cancer-related mortality in the United States and around the world. There are > 90 million current and ex-smokers in the United States who are at increased risk of lung cancer. The published data from the National Lung Screening Trial (NLST) suggest that yearly screening with low-dose thoracic CT scan in heavy smokers can reduce lung cancer mortality by 20% and all-cause mortality by 7%. However, to implement this program nationwide using the NLST inclusion and exclusion criteria would be extremely expensive, with CT scan costs alone > $2 billion per annum. In this article, we offer a possible low-cost strategy to risk-stratify smokers on the basis of spirometry measurements and emphysema scoring by radiologists on CT scans.
肺癌是美国和全球癌症相关死亡的主要原因。在美国，目前有超过 9000 万的现吸烟者和前吸烟者，他们患肺癌的风险增加。国家肺癌筛查试验（NLST）的已发表数据表明，每年对重度吸烟者进行低剂量胸部 CT 扫描筛查，可以使肺癌死亡率降低 20%，全因死亡率降低 7%。然而，按照 NLST 的纳入和排除标准，在全国范围内实施这一方案的费用将极其昂贵，仅 CT 扫描的费用每年就超过 20 亿美元。在本文中，我们提供了一种可能的低成本策略，根据肺量计测量和放射科医生对 CT 扫描的肺气肿评分，对吸烟者进行风险分层。
