Eddy D M
Center for Health Policy Research and Education, Duke University, Durham, North Carolina.
Ann Intern Med. 1989 Aug 1;111(3):232-7. doi: 10.7326/0003-4819-111-3-232.
Lung cancer is the commonest cause of death from cancer in both men and women, with approximately 152,000 new cases and 139,000 deaths in 1988. The incidence and mortality rates are increasing rapidly in women. Two main tests have been used to screen for lung cancer: chest roentgenography and sputum cytology. Four recent controlled trials and one case-control study failed, however, to show that screening reduces lung cancer mortality even in high-risk persons (smokers). In the Mayo Lung Project, for example, the lung cancer death rate in high-risk men offered sputum cytology and chest roentgenogram every 4 months was 3.1 per 1000 person-years, compared with 3.0 per 1000 person-years in a control group. Chest roentgenograms and sputum cytology lead to false-positive test results in smokers of approximately 5% and 0.5%, respectively. Because of the lack of evidence of benefit and because of its potential harms and costs, screening for lung cancer is not recommended.
肺癌是男性和女性癌症死亡的最常见原因，1988年约有15.2万新发病例和13.9万例死亡。女性的发病率和死亡率正在迅速上升。两种主要的肺癌筛查方法是胸部X线检查和痰细胞学检查。然而，最近的四项对照试验和一项病例对照研究未能表明筛查能降低肺癌死亡率，即使是在高危人群（吸烟者）中。例如，在梅奥肺癌项目中，每4个月接受痰细胞学检查和胸部X线检查的高危男性肺癌死亡率为每1000人年3.1例，而对照组为每1000人年3.0例。胸部X线检查和痰细胞学检查在吸烟者中的假阳性率分别约为5%和0.5%。由于缺乏获益证据，且存在潜在危害和成本，不建议进行肺癌筛查。
