肺癌筛查的前置时间长度。
Duration of lead time in screening for lung cancer.
机构信息
Department of Medicine (retired), Hadassah Medical Center, PO Box 3894, 91037, Jerusalem, Israel.
出版信息
BMC Pulm Med. 2021 Jan 6;21(1):4. doi: 10.1186/s12890-020-01385-3.
BACKGROUND
Screening for lung cancer has used chest radiography (CR), low dose computed tomography (LDCT) and sputum cytology (SC). Estimates of the lead time (LT), i.e., the time interval from detection of lung cancer by screening to the development of symptoms, have been derived from longitudinal studies of populations at risk, tumor doubling time (DT), the ratio between its prevalence at the first round of screening and its annual incidence during follow-up, and by probability modeling derived from the results of screening trials.
OBJECTIVE
To review and update the estimates of LT of lung cancer.
METHODS
A non-systematic search of the literature for estimates of LT and screening trials. Search of the reference sections of the retrieved papers for additional relevant studies. Calculation of LTs derived from these studies.
RESULTS
LT since detection by CR was 0.8-1.1 years if derived from longitudinal studies; 0.6-2.1 years if derived from prevalence / incidence ratios; 0.2 years if derived from the average tumor DT; and 0.2-1.0 if derived from probability modeling. LT since detection by LDCT was 1.1-3.5 if derived from prevalence / incidence ratios; 3.9 if derived from DT; and 0.9 if derived from probability modeling. LT since detection of squamous cell cancer by SC in persons with normal CR was 1.3-1.5 if derived from prevalence/incidence ratios; and 2.1 years if derived from the DT of squamous cell cancer.
CONCLUSIONS
Most estimates of the LT yield values of 0.2-1.5 years for detection by CR; of 0.9-3.5 years for detection by LDCT; and about 2 years or less for detection of squamous cell cancer by SC in persons with normal CR. The heterogeneity of the screening trials and methods of derivation may account for the variability of LT estimates.
背景
肺癌筛查使用了胸部 X 光摄影（CR）、低剂量计算机断层扫描（LDCT）和痰液细胞学检查（SC）。通过对处于风险中的人群进行纵向研究、肿瘤倍增时间（DT）、首轮筛查时的患病率与随访期间年度发病率的比值，以及通过筛查试验的结果得出的概率模型，对领先时间（LT）进行了估计，即通过筛查发现肺癌到出现症状的时间间隔。
目的
回顾和更新肺癌 LT 的估计值。
方法
对 LT 和筛查试验的文献进行非系统性检索。检索检索到的论文的参考文献部分以获取其他相关研究。从这些研究中计算 LT。
结果
如果源自纵向研究，则源自 CR 检测的 LT 为 0.8-1.1 年；如果源自患病率/发病率比值，则为 0.6-2.1 年；如果源自平均肿瘤 DT，则为 0.2 年；如果源自概率模型，则为 0.2-1.0 年。如果源自患病率/发病率比值，则源自 LDCT 检测的 LT 为 1.1-3.5 年；如果源自 DT，则为 3.9 年；如果源自概率模型，则为 0.9 年。如果源自 SC 检测的 CR 正常的人鳞状细胞癌，则 LT 为 1.3-1.5 年，如果源自患病率/发病率比值，则为 2.1 年；如果源自鳞状细胞癌的 DT，则为 2.1 年。
结论
大多数 LT 估计值为 CR 检测的 0.2-1.5 年；LDCT 检测的 0.9-3.5 年；CR 正常的人通过 SC 检测的鳞状细胞癌为 2 年或更短。筛查试验和推导方法的异质性可能是 LT 估计值变化的原因。
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