Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
The Prince Charles Hospital, University of Queensland School of Medicine, Brisbane, Australia.
J Thorac Oncol. 2019 Sep;14(9):1513-1527. doi: 10.1016/j.jtho.2019.06.011. Epub 2019 Jun 19.
Lung cancer remains the leading cause of cancer-related mortality worldwide. Tobacco consumption remains the most important risk factor. Although the prevalence of smoking has decreased overall, it continues to be a significant burden for global health. It is estimated that there are still nearly 1 billion cigarette smokers worldwide. Prevention strategies have largely focused on tobacco control and prevention. However, we have witnessed a dramatic increase in the use of e-cigarettes and other vaping products. Primary chemoprevention has historically not been a successful strategy for lung cancer; however, focused approaches in specific groups of patients at high risk for development of lung cancer are underway. The majority of cases with NSCLC are diagnosed with locally advanced or metastatic disease, where the overall prognosis remains very poor. Early-stage NSCLC on the other hand has a much better prognosis and can usually be treated radically with either surgical resection or radical radiotherapy, with relatively favorable long-term outcomes. In addition to image-based screening, other methods such as breath-based and biofluid-based approaches are now being investigated for early detection of NSCLC. This review will focus on recent advancements in the field of prevention, screening, and early detection of NSCLC.
肺癌仍然是全球癌症相关死亡的主要原因。烟草消费仍然是最重要的危险因素。尽管吸烟的流行率总体上有所下降,但它仍然是全球健康的一个重大负担。据估计,全球仍有近 10 亿烟民。预防策略主要集中在烟草控制和预防上。然而,我们已经看到电子烟和其他蒸气产品的使用急剧增加。历史上,化学预防在肺癌方面并不是一个成功的策略;然而,针对高危肺癌发展的特定患者群体的集中方法正在进行中。大多数非小细胞肺癌(NSCLC)病例被诊断为局部晚期或转移性疾病,总体预后仍然非常差。另一方面,早期 NSCLC 预后要好得多,通常可以通过手术切除或根治性放疗来根治,长期预后相对较好。除了基于影像学的筛查外,现在还在研究基于呼吸和生物流体的其他方法,以用于 NSCLC 的早期检测。这篇综述将重点介绍 NSCLC 的预防、筛查和早期检测领域的最新进展。