Department of Radiology and Medical Imaging, CHU Nîmes, Univ. Montpellier, EA2415, Nîmes, France.
Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nîmes, Univ. Montpellier, Nîmes, France.
Eur J Cancer. 2020 Jul;134:107-114. doi: 10.1016/j.ejca.2020.04.035. Epub 2020 Jun 2.
Lung cancer (LC) has the highest cancer mortality worldwide with poor prognosis. Screening with low-dose computed tomography (LDCT) in populations highly exposed to tobacco has been proposed to improve LC prognosis. Our objective was to perform a systematic review and meta-analysis to evaluate the efficacy of screening by LDCT compared with any other intervention in populations who reported tobacco consumption for more than 15 years on LC and overall mortality.
We searched randomised controlled trials (RCTs) studying screening by LDCT compared with any other intervention in a population who reported an average smoking history greater than 15 pack-years from inception until the 19th February 2018 using Medline and Cochrane Library databases. Publication selection and data extraction were made independently by two double-blind reviewers.
Seven RCTs were included in the meta-analysis which corresponds to 84,558 participants. A significant relative reduction of LC-specific mortality of 17% (risk ratio [RR] = 0.83, 95% confidence interval [CI]: 0.76-0.91) and a relative reduction of overall mortality of 4% (RR = 0.96, 95% CI: 0.92-1.00) was observed in the screening group compared with the control group.
In populations highly exposed to tobacco, screening by LDCT reduces lung cancer mortality.
肺癌（LC）是全球癌症死亡率最高的疾病，预后较差。在高暴露于烟草的人群中进行低剂量计算机断层扫描（LDCT）筛查，被认为可以改善 LC 的预后。我们的目的是进行系统评价和荟萃分析，以评估与任何其他干预措施相比，LDCT 筛查在报告吸烟史超过 15 年的人群中对 LC 和全因死亡率的疗效。
我们检索了从开始到 2018 年 2 月 19 日，使用 Medline 和 Cochrane 图书馆数据库，在报告平均吸烟史超过 15 包年的人群中，研究 LDCT 筛查与任何其他干预措施相比的随机对照试验（RCT）。由两名双盲审稿人独立进行文献选择和数据提取。
共有 7 项 RCT 纳入荟萃分析，共计 84558 名参与者。与对照组相比，筛查组 LC 特异性死亡率相对降低 17%（风险比 [RR] = 0.83，95%置信区间 [CI]：0.76-0.91），总死亡率相对降低 4%（RR = 0.96，95% CI：0.92-1.00）。
在高暴露于烟草的人群中，LDCT 筛查可降低肺癌死亡率。
