Harb Tarek, Alhafi Anas, Tfayli Arafat H
Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Front Oncol. 2023 Aug 4;13:1164574. doi: 10.3389/fonc.2023.1164574. eCollection 2023.
In Lebanon, a dedicated screening program for lung cancer is absent. Screening is largely based on the recommendation of an informed physician or the initiative of a patient. To better understand the situation, it is important to look at the available data on patients currently being screened for lung cancer in this country. Our aim in this study is to review the data and compare it with that in the literature as well as to assess the efficacy of the screening process followed.
Our study accessed the electronic medical records of patients at the American University of Beirut Medical Center (AUBMC), a tertiary care center in Lebanon. We collected information on patients who underwent screening low-dose computed tomography (LDCT) scan between June 2019 and June 2021 inclusive. Records of all patients who underwent a non-contrast computed tomography (CT) scan at AUBMC during this period were collected and analyzed.
On average, our population had a 52.6 pack-year smoking history. Moreover, 47% of our population had an accurate pack-year reported, while 12% did not have enough information to even estimate their pack-year history. When looking at the accurate and estimated data, 5% of our population did not even meet the ≥20 pack-year smoking history. Eight patients had positive findings on the screening LDCT, which we defined as suspicious findings that require further workup (e.g., PET/CT or biopsy) or other significant incidental findings.
A well-organized program for lung cancer screening in Lebanon is absent. Screening largely depends on the initiative of the physician or the patient. We were able to uncover multiple flaws in the screening method used, including poor documentation and follow-up. Although the screening method adopted retained some benefits in terms of detecting early malignancy, it lacked proper organization and was not ideal. A better, systematized screening program is needed to have optimal outcomes.
在黎巴嫩，缺乏专门的肺癌筛查项目。筛查很大程度上基于明智的医生建议或患者的主动要求。为了更好地了解情况，查看该国目前正在接受肺癌筛查的患者的现有数据很重要。我们这项研究的目的是回顾这些数据并将其与文献中的数据进行比较，以及评估所采用的筛查过程的有效性。
我们的研究获取了黎巴嫩三级医疗中心贝鲁特美国大学医疗中心（AUBMC）患者的电子病历。我们收集了在2019年6月至2021年6月（含）期间接受低剂量计算机断层扫描（LDCT）筛查的患者信息。收集并分析了在此期间在AUBMC接受非增强计算机断层扫描（CT）的所有患者的记录。
平均而言，我们研究人群的吸烟史为52.6包年。此外，47%的研究人群有准确报告的包年数，而12%的人甚至没有足够信息来估算他们的包年史。查看准确和估算数据时，5%的研究人群甚至未达到≥20包年的吸烟史。8名患者的筛查LDCT有阳性结果，我们将其定义为需要进一步检查（如PET/CT或活检）的可疑结果或其他重要的偶然发现。
黎巴嫩缺乏一个组织良好的肺癌筛查项目。筛查很大程度上取决于医生或患者的主动性。我们发现所采用的筛查方法存在多个缺陷，包括记录不完善和随访不足。尽管所采用的筛查方法在检测早期恶性肿瘤方面仍有一些益处，但缺乏适当的组织且并不理想。需要一个更好的、系统化的筛查项目以获得最佳结果。
