Fontana R S, Sanderson D R, Woolner L B, Taylor W F, Miller W E, Muhm J R
J Occup Med. 1986 Aug;28(8):746-50. doi: 10.1097/00043764-198608000-00038.
The National Cancer Institute has sponsored three randomized controlled trials of screening for early lung cancer in large, high-risk populations to determine whether lung cancer detection can be improved by adding sputum cytological screening every 4 months to chest roentgenography done either yearly or every 4 months; and lung cancer mortality can be significantly reduced by this type of screening program, followed by appropriate treatment. Results of the three trials suggest that sputum cytology alone detects 15% to 20% of lung cancers, almost all of which are squamous cancers with a favorable prognosis; and chest roentgenography may be a more effective test for early-stage lung cancer than previous reports have suggested. Nevertheless, results of the randomized trial conducted at the Mayo Clinic showed that offering both procedures to high-risk outpatients every 4 months conferred no mortality advantage over standard medical practice that included recommended annual testing.
美国国立癌症研究所资助了三项随机对照试验，在大型高危人群中筛查早期肺癌，以确定在每年或每4个月进行一次胸部X线检查的基础上，每4个月增加一次痰细胞学筛查是否能提高肺癌的检出率；以及通过这种筛查方案并给予适当治疗，是否能显著降低肺癌死亡率。三项试验的结果表明，单独进行痰细胞学检查可检测出15%至20%的肺癌，几乎所有这些都是预后良好的鳞状癌；胸部X线检查对早期肺癌可能比以前的报告显示的更有效。然而，梅奥诊所进行的随机试验结果表明，每4个月为高危门诊患者同时提供这两种检查，与包括推荐的年度检查在内的标准医疗实践相比，在死亡率方面没有优势。
