Department of Integrative Oncology, British Columbia Cancer Research Institute, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Shanghai Respiratory Research Institute and Chinese Alliance Against Cancer, Shanghai, People's Republic of China.
J Thorac Oncol. 2024 Jan;19(1):36-51. doi: 10.1016/j.jtho.2023.07.019. Epub 2023 Jul 23.
Low-dose computed tomography (LDCT) screening for lung cancer substantially reduces mortality from lung cancer, as revealed in randomized controlled trials and meta-analyses. This review is based on the ninth CT screening symposium of the International Association for the Study of Lung Cancer, which focuses on the major themes pertinent to the successful global implementation of LDCT screening and develops a strategy to further the implementation of lung cancer screening globally. These recommendations provide a 5-year roadmap to advance the implementation of LDCT screening globally, including the following: (1) establish universal screening program quality indicators; (2) establish evidence-based criteria to identify individuals who have never smoked but are at high-risk of developing lung cancer; (3) develop recommendations for incidentally detected lung nodule tracking and management protocols to complement programmatic lung cancer screening; (4) Integrate artificial intelligence and biomarkers to increase the prediction of malignancy in suspicious CT screen-detected lesions; and (5) standardize high-quality performance artificial intelligence protocols that lead to substantial reductions in costs, resource utilization and radiologist reporting time; (6) personalize CT screening intervals on the basis of an individual's lung cancer risk; (7) develop evidence to support clinical management and cost-effectiveness of other identified abnormalities on a lung cancer screening CT; (8) develop publicly accessible, easy-to-use geospatial tools to plan and monitor equitable access to screening services; and (9) establish a global shared education resource for lung cancer screening CT to ensure high-quality reading and reporting.
低剂量计算机断层扫描（LDCT）筛查肺癌可显著降低肺癌死亡率，这已在随机对照试验和荟萃分析中得到证实。这篇综述基于国际肺癌研究协会第九届 CT 筛查研讨会，重点关注成功实施全球 LDCT 筛查的主要主题，并制定了进一步在全球实施肺癌筛查的策略。这些建议为推进全球 LDCT 筛查的实施提供了一个 5 年路线图，包括以下内容：（1）建立通用筛查计划质量指标；（2）建立基于证据的标准，以确定从未吸烟但患肺癌风险高的个体；（3）制定偶然发现的肺结节跟踪和管理协议建议，以补充计划的肺癌筛查；（4）整合人工智能和生物标志物，以提高可疑 CT 筛查检测病变恶性的预测能力；（5）标准化高质量的人工智能协议，从而大幅降低成本、资源利用和放射科医生报告时间；（6）根据个体的肺癌风险个性化 CT 筛查间隔；（7）制定证据支持肺癌筛查 CT 上其他已确定异常的临床管理和成本效益；（8）开发易于使用的公共地理空间工具，以规划和监测公平获得筛查服务的机会；（9）建立一个全球共享的肺癌筛查 CT 教育资源，以确保高质量的阅读和报告。
