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欧洲肺癌筛查立场声明。

European position statement on lung cancer screening.

机构信息

Center for Medical Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

Department of Radiology, Royal Brompton Hospital, London, UK.

出版信息

Lancet Oncol. 2017 Dec;18(12):e754-e766. doi: 10.1016/S1470-2045(17)30861-6.

Abstract

Lung cancer screening with low-dose CT can save lives. This European Union (EU) position statement presents the available evidence and the major issues that need to be addressed to ensure the successful implementation of low-dose CT lung cancer screening in Europe. This statement identified specific actions required by the European lung cancer screening community to adopt before the implementation of low-dose CT lung cancer screening. This position statement recommends the following actions: a risk stratification approach should be used for future lung cancer low-dose CT programmes; that individuals who enter screening programmes should be provided with information on the benefits and harms of screening, and smoking cessation should be offered to all current smokers; that management of detected solid nodules should use semi-automatically measured volume and volume-doubling time; that national quality assurance boards should be set up to oversee technical standards; that a lung nodule management pathway should be established and incorporated into clinical practice with a tailored screening approach; that non-calcified baseline lung nodules greater than 300 mm, and new lung nodules greater than 200 mm, should be managed in multidisciplinary teams according to this EU position statement recommendations to ensure that patients receive the most appropriate treatment; and planning for implementation of low-dose CT screening should start throughout Europe as soon as possible. European countries need to set a timeline for implementing lung cancer screening.

摘要

低剂量 CT 肺癌筛查可挽救生命。本欧盟立场声明提出了现有证据和需要解决的主要问题,以确保低剂量 CT 肺癌筛查在欧洲的成功实施。本声明确定了欧洲肺癌筛查界在实施低剂量 CT 肺癌筛查之前需要采取的具体行动。本立场声明建议采取以下行动:未来的肺癌低剂量 CT 计划应采用风险分层方法;应向参加筛查计划的个体提供有关筛查的益处和危害的信息,并向所有当前吸烟者提供戒烟服务;应使用半自动测量体积和倍增时间来管理检测到的实性结节;应设立国家质量保证委员会来监督技术标准;应建立肺结节管理途径,并将其纳入临床实践,采用量身定制的筛查方法;应根据本欧盟立场声明的建议,由多学科团队管理大于 300mm 的非钙化基线肺结节和大于 200mm 的新肺结节,以确保患者获得最合适的治疗;并应尽快在整个欧洲开始实施低剂量 CT 筛查的规划。欧洲国家需要为实施肺癌筛查制定时间表。

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