Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
Semin Respir Crit Care Med. 2013 Dec;34(6):727-37. doi: 10.1055/s-0033-1358549. Epub 2013 Nov 20.
The National Lung Screening Trial demonstrated that lung cancer screening with three annual low-dose computed tomographic scans has the potential to reduce lung cancer-specific mortality by 20% in an older population of heavy smokers. This was a great achievement by the National Lung Screening Trial (NLST) investigators, but this should be viewed as an important first step in an unfinished process. Many major questions remain about how to best realize this mortality reduction in a practical real-world context. Screening for lung cancer will be most effective if it is accompanied by continued research into risk modeling, patient communication strategies, and biomarkers. For clinicians establishing a program of lung cancer screening, we encourage this to be done in a responsible fashion, adhering to practices specified in the design of the NLST, and with careful attention given to proper management of screen-detected abnormalities and maintenance of screening registries.
国家肺癌筛查试验表明，在老年重度吸烟者中，每年进行三次低剂量计算机断层扫描肺癌筛查，有降低 20%肺癌特异性死亡率的潜力。这是国家肺癌筛查试验（NLST）研究人员的一项重大成就，但这应该被视为一个尚未完成的过程中的重要第一步。关于如何在实际的现实环境中最好地实现这种死亡率降低，仍然存在许多重大问题。如果肺癌筛查伴随着对风险建模、患者沟通策略和生物标志物的持续研究，那么它将最有效。对于临床医生来说，我们鼓励他们以负责任的方式建立肺癌筛查计划，遵循 NLST 设计中规定的实践，并仔细注意对筛查发现的异常的适当管理和筛查登记的维护。
