Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK; Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
Clin Oncol (R Coll Radiol). 2022 Nov;34(11):708-715. doi: 10.1016/j.clon.2022.08.036. Epub 2022 Sep 26.
Lung cancer remains the most significant cause of cancer death, accounting for about 20% of all cancer-related mortality. A significant reason for this is delayed diagnosis, either due to lack of symptoms in early-stage disease or presentation with non-specific symptoms common with a broad range of alternative diagnoses. More is needed in terms of increasing public awareness, providing adequate healthcare professional education and implementing clinical pathways that improve the earlier diagnosis of symptomatic lung cancer. Low-dose computed tomography screening of high-risk, asymptomatic populations has been shown to reduce lung cancer mortality, with focus now shifting towards how best to implement lung cancer screening on a wider scale in a safe, efficient and cost-effective manner. For maximum benefit, efforts must be made to optimise uptake, especially among high-risk populations with significant socioeconomic deprivation, as well as successfully incorporate tobacco-dependency treatment. Quality assured programme management will be critical to minimising screening-related harms and adequately managing incidental findings. By undertaking the above, there can be optimism that lung cancer outcomes can be improved significantly in the near future.
肺癌仍然是癌症死亡的主要原因，约占所有癌症相关死亡率的 20%。造成这种情况的一个重要原因是诊断延迟，要么是因为早期疾病没有症状，要么是因为出现了与广泛替代诊断共有的非特异性症状。需要在提高公众意识、为医疗保健专业人员提供充足的教育以及实施改善有症状肺癌早期诊断的临床路径方面做出更多努力。低剂量计算机断层扫描对高危、无症状人群进行筛查已被证明可以降低肺癌死亡率，现在的重点转向如何以安全、有效和具有成本效益的方式更广泛地实施肺癌筛查。为了获得最大的益处，必须努力优化参与度，特别是在高危人群中，这些人群存在显著的社会经济贫困，同时还要成功地纳入对烟草依赖的治疗。有保证的质量方案管理对于将筛查相关危害降至最低以及充分管理偶然发现至关重要。通过采取上述措施，可以乐观地认为，在不久的将来，肺癌的治疗结果将得到显著改善。
