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肺癌筛查:隐匿的公共卫生紧急情况。

Lung cancer screening: the hidden public health emergency.

作者信息

Stone Emily, Dodd Rachael H, Marshall Henry, Bonevski Billie, Rankin Nicole M

机构信息

Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital Sydney, NSW, Australia;School of Clinical Medicine, UNSW Sydney, Australia; School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia;

School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The Daffodil Centre, a joint venture between Cancer Council NSW and University of Sydney, Australia.

出版信息

Public Health Res Pract. 2023 Mar 15;33(1):3312302. doi: 10.17061/phrp3312302.

Abstract

Lung cancer causes nearly 2 million deaths per year worldwide, and cases continue to rise. Most lung cancer is diagnosed at late, incurable stages, and the five-year survival is a fraction of that for other common cancers, including breast, prostate, melanoma and colorectal cancer. Lung cancer screening (LCS) in high-risk populations using low-dose computed tomography (LDCT) could potentially save thousands of lives per year by shifting the stage at diagnosis to early curable disease. Although an LCS program has not yet started in Australia, two trials have provided local data on the feasibility, selection criteria and outcomes. A government-commissioned report has detailed a potential national program, and Federal Budget funding has been committed to early feasibility projects that include population-specific consultations with, for example, Aboriginal and Torres Strait Islander communities who are at higher risk of lung cancer due to high smoking rates. Effective recruitment to LCS, embedded smoking cessation and the provision of subsequent lung cancer care to all at-risk Australians remain key priorities for any future LCS program.

摘要

肺癌每年在全球导致近200万人死亡,且病例数持续上升。大多数肺癌在晚期、无法治愈的阶段被诊断出来,其五年生存率仅为其他常见癌症(包括乳腺癌、前列腺癌、黑色素瘤和结直肠癌)的一小部分。在高危人群中使用低剂量计算机断层扫描(LDCT)进行肺癌筛查(LCS),有可能通过将诊断阶段提前到可治愈的早期疾病,每年挽救数千人的生命。尽管澳大利亚尚未启动肺癌筛查项目,但两项试验已经提供了关于可行性、选择标准和结果的本地数据。一份政府委托的报告详细介绍了一个潜在的全国性项目,联邦预算已拨款用于早期可行性项目,其中包括针对特定人群的咨询,例如因吸烟率高而患肺癌风险较高的原住民和托雷斯海峡岛民社区。有效地招募人群参与肺癌筛查、深入开展戒烟工作以及为所有高危澳大利亚人提供后续肺癌护理,仍然是未来任何肺癌筛查项目的关键优先事项。

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