Zhang Yang, Chen Haiquan
Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Institute of Thoracic Oncology, Fudan University, Shanghai, China.
Transl Lung Cancer Res. 2021 May;10(5):2389-2394. doi: 10.21037/tlcr.2020.03.16.
The National Lung Screening Trial (NLST) revealed that low-dose computed tomography (LDCT) screening reduced lung cancer mortality by 20.0%. In China, LDCT is very cheap and easy to access. As a result, LDCT screening is not limited to "high-risk" population defined by the NLST trial. The results of LDCT screening in China are also quite different from that in Western countries. LDCT detected lung cancer in a significant proportion of young, female and non-smokers in China. There is also a higher proportion of adenocarcinoma (ADC), a lower proportion of squamous cell carcinoma, and a higher proportion of early-stage 0/I disease among LDCT-detected lung cancer in China. The issue of overdiagnosis and overtreatment is discussed. Finally, we call the global attention to clarify the etiology of lung cancer in young female non-smokers.
国家肺癌筛查试验（NLST）表明，低剂量计算机断层扫描（LDCT）筛查可使肺癌死亡率降低20.0%。在中国，LDCT价格低廉且易于获得。因此，LDCT筛查并不局限于NLST试验所定义的“高危”人群。中国LDCT筛查的结果也与西方国家有很大不同。在中国，LDCT在相当比例的年轻、女性和非吸烟者中检测出肺癌。在LDCT检测出的肺癌中，腺癌（ADC）比例较高，鳞状细胞癌比例较低，早期0/I期疾病比例较高。文中讨论了过度诊断和过度治疗的问题。最后，我们呼吁全球关注明确年轻女性非吸烟者肺癌的病因。
