Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
Division of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
J Med Screen. 2021 Dec;28(4):488-493. doi: 10.1177/09691413211013058. Epub 2021 May 4.
Lung cancer is the leading cancer killer in women, resulting in more deaths than breast, cervical and ovarian cancer combined. Screening for lung cancer has been shown to significantly reduce mortality, with some evidence that women may have a greater benefit. This study demonstrates that a population of women being screened for breast cancer may greatly benefit from screening for lung cancer.
Data from 18,040 women who were screened for breast cancer in 2015 at two imaging facilities that also performed lung screening were reviewed. A natural language-processing algorithm followed by a manual chart review identified women eligible for lung cancer screening by U.S. Preventive Services Task Force (USPSTF) criteria. A chart review of these eligible women was performed to determine subsequent enrollment in a lung screening program (2016-2019), current screening eligibility, cancer diagnoses and cancer-related outcomes.
Natural language processing identified 685 women undergoing screening mammography who were also potentially eligible for lung screening based on age and smoking history. Manual chart review confirmed 251 were eligible under USPSTF criteria. By June 2019, 63 (25%) had enrolled in lung screening, of which three were diagnosed with screening-detected lung cancer resulting in zero deaths. Of 188 not screened, seven were diagnosed with lung cancer resulting in five deaths by study end. Four women received a diagnosis of breast cancer with no deaths.
Women screened for breast cancer are dying from lung cancer. We must capitalize on reducing barriers to improve screening for lung cancer among high-risk women.
肺癌是女性的主要癌症杀手，导致的死亡人数超过乳腺癌、宫颈癌和卵巢癌的总和。肺癌筛查已被证明能显著降低死亡率，且有证据表明女性可能受益更大。本研究表明，正在接受乳腺癌筛查的女性人群可能会极大地受益于肺癌筛查。
对 2015 年在两家同时进行肺癌筛查的影像机构接受乳腺癌筛查的 18040 名女性的数据进行了回顾。自然语言处理算法和手动图表审查确定了符合美国预防服务工作组（USPSTF）标准的肺癌筛查女性。对这些符合条件的女性进行了图表审查，以确定其是否随后参加了肺癌筛查计划（2016-2019 年）、目前的筛查资格、癌症诊断和癌症相关结局。
自然语言处理确定了 685 名正在接受乳房 X 线筛查的女性，根据年龄和吸烟史，她们也可能有资格接受肺癌筛查。手动图表审查确认了 251 名符合 USPSTF 标准的女性符合条件。截至 2019 年 6 月，有 63 名（25%）参加了肺癌筛查，其中 3 名被诊断为筛查发现的肺癌，且无死亡病例。未进行筛查的 188 名女性中，有 7 名被诊断为肺癌，截至研究结束时，其中 5 名死亡。有 4 名女性被诊断为乳腺癌，无死亡病例。
正在接受乳腺癌筛查的女性因肺癌而死亡。我们必须利用这一机会，减少障碍，提高高危女性的肺癌筛查率。
