Sir Charles Gairdner Hospital, Perth, WA
Busselton Population Medical Research Institute, Busselton, WA.
Med J Aust. 2016 Jun 20;204(11):406. doi: 10.5694/mja16.00043.
To estimate the proportion of ever-smokers who are eligible for lung cancer screening in an Australian cohort, and to evaluate the effect of spirometry in defining chronic obstructive pulmonary disease (COPD) when assessing screening eligibility.
Cross-sectional study of 3586 individuals aged 50-68 years who live in the Busselton Shire of Western Australia.
Proportion of ever-smokers eligible for lung cancer screening based on United States Preventive Services Task Force (USPSTF) criteria, and PLCOm2012 lung cancer risk > 1.5%. The effect of using self-reported COPD, symptoms consistent with COPD, or spirometry to define COPD for screening eligibility according to the PLCOm2012 criteria.
Of ever-smokers aged 55-68 years, 254 (20.1%) would be eligible for screening according to USPSTF criteria; fewer would be eligible according to PLCOm2012 criteria (225, 17.9%; P = 0.004). This is equivalent to 8.9-10.0% of the total population aged 55-68 years, which suggests about 450 000 individuals in Australia may be eligible for lung cancer screening. The proportions of eligible participants were not significantly different whether spirometry results or symptoms consistent with COPD were used to determine PLCOm2012 risk.
The proportion of ever-smokers in this population who were eligible for lung cancer screening was 17.9-20.1%. Using symptoms to define COPD is an appropriate surrogate measure for spirometry when determining the presence of COPD in this population. There are significant challenges for policy makers on how to identify and recruit these eligible individuals from the wider population.
评估澳大利亚队列中符合肺癌筛查条件的曾吸烟者比例，并评估在评估筛查资格时使用肺活量计定义慢性阻塞性肺疾病（COPD）对定义 COPD 的影响。
对居住在西澳大利亚州巴斯顿郡的 3586 名年龄在 50-68 岁的个体进行横断面研究。
根据美国预防服务工作组（USPSTF）标准和 PLCOm2012 肺癌风险>1.5%，确定曾吸烟者中符合肺癌筛查条件的比例。根据 PLCOm2012 标准，使用自我报告的 COPD、与 COPD 一致的症状或肺活量计来定义 COPD 对筛查资格的影响。
根据 USPSTF 标准，55-68 岁的曾吸烟者中，有 254 人（20.1%）符合筛查条件；根据 PLCOm2012 标准，符合条件的人数更少（225 人，17.9%；P=0.004）。这相当于 55-68 岁总人群的 8.9-10.0%，表明澳大利亚约有 450000 人可能有资格接受肺癌筛查。无论使用肺活量计结果还是与 COPD 一致的症状来确定 PLCOm2012 风险，符合条件的参与者比例均无显着差异。
该人群中曾吸烟者中有 17.9-20.1%符合肺癌筛查条件。在确定该人群中 COPD 的存在时，使用症状来定义 COPD 是肺活量计的合适替代指标。政策制定者在如何从更广泛的人群中识别和招募这些合格的个体方面面临重大挑战。
