Smit Arthur A J, Moons-Pasic Arifa, Bresser Paul
OLVG, afd. Longziekten, Amsterdam.
Ned Tijdschr Geneeskd. 2015;159:A8933.
Previous studies of low-dose computed tomography (CT) screening for lung cancer have shown a decrease in lung-cancer-related deaths. Data from the NELSON trial, using new thresholds for defining a positive test, resulted in less over-diagnosis without a decrease in test-specific sensitivity. However, in our opinion it is still too early to implement screening in the Netherlands. Further development of the optimal screening algorithm based on defined volumetric thresholds and stratified by personal characteristics such as age, smoking habits, gender and comorbidities, will probably result in a better balance between the harms and benefits of lung-cancer screening to individuals and society.
先前关于低剂量计算机断层扫描（CT）筛查肺癌的研究表明，肺癌相关死亡人数有所减少。NELSON试验的数据采用了新的阳性检测阈值，减少了过度诊断，同时检测特异性敏感性并未降低。然而，在我们看来，在荷兰实施筛查仍为时过早。基于确定的体积阈值并按年龄、吸烟习惯、性别和合并症等个人特征进行分层，进一步开发最佳筛查算法，可能会在肺癌筛查对个人和社会的危害与益处之间实现更好的平衡。
