Rzyman Witold, Didkowska Joanna, Dziedzic Robert, Grodzki Tomasz, Orłowski Tadeusz, Szurowska Edyta, Langfort Renata, Biernat Wojciech, Kowalski Dariusz, Dyszkiewicz Wojciech, Jędrzejczyk Tadeusz, Zdrojewski Tomasz, Nawrocki Sergiusz, Jassem Ewa, Adamek Mariusz
Department of Thoracic Surgery, Medical University of Gdansk, Sklodowskiej Curie 3a, 80-210 Gdansk, Poland.
Adv Respir Med. 2018;86(1):53-74. doi: 10.5603/ARM.2018.0009.
Lung cancer is the most common cancer in Poland and worldwide, and the leading cause of cancer-related deaths. Compared to the present day, the annual number of new cases of lung cancer will have increased by approximately 50%, by 2030. The overall ratio of mortality to incidence totals 0.87 and is among the highest. The five-year survival rate in Poland has recently achieved 13.4%. In 2015, lung cancer screening using low-dose computed tomography (LDCT) was introduced to routine clinical practice in the United States following the publication of the largest randomised study, The National Lung Screening Trial. The implementation of screening programmes in Poland and the rest of Europe also seems unavoidable. Due to the differences, both in the socioeconomic considerations and healthcare funding, compared to that in the United States, the current approach comes down to the awaited results of the European randomised study, NELSON.
During the meeting of an expert panel at the "Torakoneptunalia 2016" conference in Jastarnia, Poland, a decision was made to summarise and publish the current data on LDCT lung cancer screening in the form of recommendations, or a position statement. The document was prepared by a team composed of a radiologist, thoracic surgeons, pulmonologists, clinical oncologists, epidemiologists, internists, health prevention specialists and pathologists. It reflects the current body of knowledge about lung cancer, its diagnosis and treatment, and provides recommendations on early detection of lung cancer using LDCT. The recommendations address the screening procedure, the requirements for the teams conducting the screening, and the requirements for radiologists, pathologists and surgeons involved in the diagnosis and treatment of patients.
While awaiting the results of the NELSON study and the European position statement on lung cancer screening methodology, the multidisciplinary group of experts presents their position, laying grounds for the development of an action plan for early detection of lung cancer in the upcoming future in Poland.
Primary and secondary prophylaxis are the principal ways to reduce lung cancer mortality. While smoking cessation is a task of utmost importance, it must be accompanied by an effective screening programme if the outcome of the disease is to be improved.
肺癌是波兰以及全球最常见的癌症，也是癌症相关死亡的主要原因。与目前相比，到2030年，肺癌新发病例的年数量将增加约50%。死亡率与发病率的总体比率总计为0.87，是最高的比率之一。波兰的五年生存率最近达到了13.4%。2015年，在最大规模的随机研究《国家肺癌筛查试验》发表后，美国将使用低剂量计算机断层扫描（LDCT）进行肺癌筛查引入了常规临床实践。在波兰和欧洲其他地区实施筛查计划似乎也是不可避免的。由于与美国相比，在社会经济考量和医疗保健资金方面存在差异，目前的方法取决于欧洲随机研究NELSON的预期结果。
在波兰雅斯塔尔尼亚举行的“2016年托拉科内普图纳利亚”会议的专家小组会议期间，决定以建议或立场声明的形式总结并公布关于LDCT肺癌筛查的当前数据。该文件由一个团队编写，团队成员包括放射科医生、胸外科医生、肺科医生、临床肿瘤学家、流行病学家、内科医生、健康预防专家和病理学家。它反映了关于肺癌及其诊断和治疗的当前知识体系，并提供了关于使用LDCT早期检测肺癌的建议。这些建议涉及筛查程序、进行筛查的团队的要求，以及参与患者诊断和治疗的放射科医生、病理学家和外科医生的要求。
在等待NELSON研究结果以及欧洲关于肺癌筛查方法的立场声明的同时，多学科专家小组提出了他们的立场，为波兰在未来制定肺癌早期检测行动计划奠定了基础。
一级和二级预防是降低肺癌死亡率的主要途径。虽然戒烟是一项至关重要的任务，但如果要改善疾病的结局，还必须辅以有效的筛查计划。
