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肺癌筛查:早期发现可降低死亡率。

Lung Cancer Screening: Early Detection Decreases Mortality.

作者信息

Nam Brian, Hamm Danny, Katurakes Nora, Mulligan Charles

机构信息

Department of Thoracic Surgery & Interventional Pulmonology, Helen F Graham Cancer Center & Research Institute, ChristianaCare.

Community Health Outreach & Education, Helen F Graham Cancer Center & Research Institute, ChristianaCare.

出版信息

Dela J Public Health. 2024 Aug 28;10(3):22-24. doi: 10.32481/djph.2024.08.07. eCollection 2024 Aug.

DOI:10.32481/djph.2024.08.07
PMID:39211408
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11356585/
Abstract

Lung cancer remains the number one cancer related mortality in the United States . While it is the third most diagnosed cancer, it is often found at an advanced stage. Survival rates for stage I lung cancer are above 70% while survival rates for stage IV lung cancer are less than 10% at five years. Methods to detect lung cancer at an earlier stage when it can be more effectively treated have been investigated for many years. These included regular chest x-rays (CXRs) and sputum samples. Unfortunately, these testing modalities did not show any benefit. This changed in 2011 when data from the National Lung Screening Trial were published. This landmark trial showed conclusively that a low-radiation dose chest computed tomography scan (LDCT) performed annually in patients with a heavy smoking history reduced lung cancer related mortality by 20%. These results have led to a nationwide effort to increase lung cancer screening. While the number of eligible patients that are being screened on a national level remains modest, significant efforts are being made at the state and local levels to increase awareness and to improve screening. These efforts have also targeted underserved areas and are focused on reducing disparities in access.

摘要

肺癌仍是美国与癌症相关的首要死因。尽管它是第三大最常被诊断出的癌症,但往往在晚期才被发现。I期肺癌的五年生存率超过70%,而IV期肺癌的五年生存率则低于10%。多年来一直在研究在肺癌更易得到有效治疗的早期阶段进行检测的方法。这些方法包括定期胸部X光检查(CXR)和痰液样本。不幸的是,这些检测方式并未显示出任何益处。2011年,当国家肺癌筛查试验的数据公布时,情况发生了变化。这项具有里程碑意义的试验确凿地表明,每年对有重度吸烟史的患者进行低辐射剂量胸部计算机断层扫描(LDCT)可使肺癌相关死亡率降低20%。这些结果促使全国范围内努力增加肺癌筛查。虽然在全国范围内接受筛查的符合条件的患者数量仍然不多,但州和地方层面正在做出重大努力,以提高认识并改善筛查。这些努力还针对服务不足的地区,并致力于减少获取筛查服务方面的差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe13/11356585/f65095a41edc/djph-103-07-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe13/11356585/f65095a41edc/djph-103-07-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe13/11356585/f65095a41edc/djph-103-07-f1.jpg

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本文引用的文献

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Screening for lung cancer: 2023 guideline update from the American Cancer Society.肺癌筛查:美国癌症协会 2023 年指南更新。
CA Cancer J Clin. 2024 Jan-Feb;74(1):50-81. doi: 10.3322/caac.21811. Epub 2023 Nov 1.
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Artificial Intelligence in Lung Cancer Screening: The Future Is Now.人工智能在肺癌筛查中的应用:未来已来。
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Evidence of Racial Disparities in the Lung Cancer Screening Process: a Systematic Review and Meta-Analysis.种族差异在肺癌筛查过程中的证据:系统评价和荟萃分析。
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Disparities in Lung Cancer Screening: A Review.肺癌筛查中的差异:综述。
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Age, Race, and Income Are Associated With Lower Screening Rates at a Safety Net Hospital.年龄、种族和收入与一家医疗保障医院较低的筛查率有关。
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Screening by chest radiograph and lung cancer mortality: the Prostate, Lung, Colorectal, and Ovarian (PLCO) randomized trial.胸部 X 光片筛查与肺癌死亡率:前列腺癌、肺癌、结直肠癌和卵巢癌(PLCO)随机试验。
JAMA. 2011 Nov 2;306(17):1865-73. doi: 10.1001/jama.2011.1591. Epub 2011 Oct 26.
10
Reduced lung-cancer mortality with low-dose computed tomographic screening.低剂量计算机断层扫描筛查可降低肺癌死亡率。
N Engl J Med. 2011 Aug 4;365(5):395-409. doi: 10.1056/NEJMoa1102873. Epub 2011 Jun 29.