Radiol Technol. 2020 Sep;92(1):23-31.
To determine whether low-dose computed tomography (LD-CT) affects the rate of early lung cancer detection in a high-risk population, how that rate compares with the rate given in the National Lung Screening Trial (NLST), whether using LD-CT provides a stage shift in lung cancer, and whether NLST results are reproducible.
Patient medical records from a Kentucky community hospital were retrospectively reviewed. Patients who were included had received LD-CT scans from January 2015 through December 2017, were aged 55 years to 79 years, had smoked for at least 30 pack-years or quit smoking in the past 15 years and were able to lie on their backs with their arms over their heads. Patients with any previous cancer were excluded. Retrospective chart review employed to collect data, and summarized quantitative data were used as measures of central tendency (ie, mean and mode).
The study included 2924 patients, with 1483 men (50.7%) and 1441 women (49.3%). Sixty-six patients (42 men, 24 women) had lung cancer, all of whom smoked a maximum of 3.5 packs of cigarettes a day. Of the 66 patients, 7 patients (10.6%) died during the 3-year study timeframe. The study found an average of 2 cancer diagnoses per 100 LD-CT scans, whereas the NLST noted 1 diagnosis for every 320 scans. Mortality rate was associated with lung cancer in this high-risk population, calculated at 239 per 100 000 patients.
Compared with NLST findings, this current study found that lung cancer is diagnosed in Kentucky residents at a higher rate, and that this group is at greater risk for developing smoking-related lung cancer. In addition, LD-CT is useful in early lung cancer detection for asymptomatic, high-risk populations and can improve quality of life, prolong life, and reduce overall health care costs.
Lung cancer is a public health care problem in the United States and specifically in Kentucky. This situation might improve if legislation prioritizes educating the medical community about the tools available for early detection of lung cancer, including LD-CT.
确定低剂量计算机断层扫描（LD-CT）是否会影响高危人群中早期肺癌的检出率，该检出率与国家肺癌筛查试验（NLST）相比如何，使用 LD-CT 是否会导致肺癌分期转移，以及 NLST 结果是否可重现。
回顾性分析肯塔基州一家社区医院的患者病历。纳入的患者在 2015 年 1 月至 2017 年 12 月期间接受了 LD-CT 扫描，年龄在 55 岁至 79 岁之间，至少吸烟 30 包年，或在过去 15 年内戒烟，且能够仰卧并将手臂举过头顶。任何既往患有癌症的患者均被排除在外。采用回顾性图表审查收集数据，并采用集中趋势的定量数据（即平均值和众数）进行总结。
本研究共纳入 2924 例患者，其中男性 1483 例（50.7%），女性 1441 例（49.3%）。66 例患者（42 例男性，24 例女性）患有肺癌，所有患者每天最多吸烟 3.5 包。在 66 例患者中，有 7 例（10.6%）在 3 年研究期间死亡。研究发现，每 100 例 LD-CT 扫描中平均有 2 例癌症诊断，而 NLST 则每 320 例扫描中发现 1 例诊断。在该高危人群中，肺癌与死亡率相关，计算得每 100 000 例患者中有 239 例死亡。
与 NLST 研究结果相比，本研究发现肯塔基州居民的肺癌诊断率更高，且该人群罹患与吸烟相关的肺癌的风险更高。此外，LD-CT 可用于无症状高危人群的早期肺癌检测，有助于提高生活质量、延长生命并降低整体医疗保健成本。
肺癌是美国，特别是肯塔基州的一个公共卫生保健问题。如果立法机构优先为医疗保健专业人员提供有关肺癌早期检测工具（包括 LD-CT）的教育，这种情况可能会有所改善。
