Hoffmann Hans, Heußel Claus Peter, Eichhorn Martin
Chirurgie, Thoraxklinik Universitätsklinikum Heidelberg, Deutschland.
Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik Universitätsklinikum Heidelberg, Deutschland.
Zentralbl Chir. 2017 Sep;142(S 01):S11-S16. doi: 10.1055/s-0043-117173. Epub 2017 Sep 28.
The evidence for the benefit and risks of lung cancer screening is based on a single large randomised controlled trial that showed a significant reduction in lung cancer mortality among lung cancer patients in the CT screening group compared to the control group. However, there are significant risks to the proven benefit. The large and unresolved problem in CT screening for lung cancer is the high rate of false positive findings. Further diagnostic work-up of these findings often requires invasive procedures. The complications that may occur are the main risk associated with CT screening for lung cancer. The German and European specialist associations are currently still holding back a recommendation for comprehensive CT screening for lung cancer. The risk benefit ratio is assessed as unfavourable. The results are awaited of the ongoing European studies ("NELSON" in the Netherlands and "LUSI" in Germany), which probably will be available by the end of 2018. Data are expected on more effective work-up algorithms with lower rates of false positive findings and thus lower complication rates. With these data, there will be a new risk benefit assessment.
肺癌筛查的益处和风险证据基于一项大型随机对照试验，该试验表明与对照组相比，CT筛查组肺癌患者的肺癌死亡率显著降低。然而，在已证实的益处之外存在重大风险。肺癌CT筛查中一个大且未解决的问题是假阳性结果的高发生率。对这些结果进行进一步诊断性检查通常需要侵入性操作。可能发生的并发症是与肺癌CT筛查相关的主要风险。德国和欧洲的专家协会目前仍未推荐进行全面的肺癌CT筛查。风险效益比被评估为不利。正在进行的欧洲研究（荷兰的“NELSON”和德国的“LUSI”）结果有待期待，可能在2018年底公布。预计将获得关于更有效的检查算法的数据，这些算法假阳性结果发生率更低，从而并发症发生率也更低。有了这些数据，将会进行新的风险效益评估。
