Department of Family and Community Medicine, Thomas Jefferson University Medical College, Philadelphia, PA, USA.
CA Cancer J Clin. 2013 Mar-Apr;63(2):107-17. doi: 10.3322/caac.21172. Epub 2013 Jan 11.
Findings from the National Cancer Institute's National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation.
美国国家癌症研究所的国家肺癌筛查试验的结果表明,在特定的高危人群中,通过每年进行低剂量计算机断层扫描筛查可以降低肺癌死亡率。这些发现表明,采用肺癌筛查可以挽救许多生命。基于国家肺癌筛查试验的结果,美国癌症协会发布了一份肺癌筛查的初步指南。该指南建议,有条件开展大容量、高质量肺癌筛查和治疗中心的临床医生,应该与年龄在 55 岁至 74 岁之间、有至少 30 包年吸烟史、目前仍在吸烟或在过去 15 年内已戒烟的、看似健康的患者,就筛查肺癌的问题展开讨论。在决定是否开始进行肺癌低剂量计算机断层扫描筛查之前,患者应该与临床医生进行知情和共同决策的过程,讨论与筛查相关的潜在益处、局限性和危害。对于目前的吸烟者,戒烟咨询仍然是临床关注的重点,应该告知他们持续存在的肺癌风险。筛查不应被视为戒烟的替代方法。