Field John K, Baldwin David R, Devaraj Anand, Oudkerk Matthijs
1 Department of Molecular and Clinical Cancer Medicine, The University of Liverpool , Liverpool , UK.
2 Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals , Nottingham , UK.
Br J Radiol. 2018 Oct;91(1090):20180243. doi: 10.1259/bjr.20180243. Epub 2018 May 24.
The European Position Statement (EUPS) expert group comprised of individuals who have been actively involved in the planning and execution of all the low dose CT (LDCT) randomised controlled European screening trials. They have argued that as lung cancer screening with LDCT saves lives, planning for implementation needs to be started by the national health organisations throughout Europe. The EUPS examined the current evidence which supports the planning for the implementation of lung cancer screening, as well as areas which require further work. One of the major areas the EUPS focused on was the management of prevalent lung nodules in CT-screening programmes, lung nodules at incident screening (newly detected) and CT-detected lung nodules in clinical practice should be managed with different protocols, due to different pre-test lung cancer probability. The EUPS provides nine recommendations and a "Call to Action" for implementation, which is naturally dependent on the outcome of the NELSON trial. Clearly, the issue is how Europe can take this forward as part of the political agenda of individual countries, as well as that of the EU Commission. An EU policy document has been developed, which focuses on the key steps in the implementation of cost effective lung cancer screening in Europe.
欧洲立场声明(EUPS)专家组由积极参与欧洲所有低剂量CT(LDCT)随机对照筛查试验的规划与实施的人员组成。他们认为,由于LDCT肺癌筛查可挽救生命,欧洲各国的卫生组织应着手进行实施规划。EUPS审查了当前支持肺癌筛查实施规划的证据以及需要进一步研究的领域。EUPS关注的一个主要领域是CT筛查项目中常见肺结节的管理,由于筛查前患肺癌的概率不同,偶然筛查(新发现)时的肺结节和临床实践中CT检测到的肺结节应采用不同的方案进行管理。EUPS提出了九条建议和一项实施“行动呼吁”,这自然取决于NELSON试验的结果。显然,问题在于欧洲如何将此作为各国以及欧盟委员会政治议程的一部分加以推进。现已制定了一份欧盟政策文件,其重点关注在欧洲实施具有成本效益的肺癌筛查的关键步骤。