Kwak Se Hyun, Kim Chi Young, Lee Sang Hoon, Kim Eun Young, Lee Eun Hye, Chang Yoon Soo
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2025 Jul;40(4):546-556. doi: 10.3904/kjim.2025.008. Epub 2025 Jul 1.
This review examines the current status and recent progress in lung cancer screening programs, focusing on low-dose computed tomography (LDCT) and emerging liquid biopsy technologies. In Korea, the National Lung Cancer Screening Program has shown promising results in reducing lung cancer mortality since its implementation in 2019. This review discusses the LDCT screening in Korea, including reductions in short-term mortality, increased screening uptake, and enhanced smoking cessation rates. Results from major international trials, including the National Lung Screening Trial, Nederlands-Leuvens Longkanker Screenings Onderzoek trial, and Multicenter Italian Lung Detection studies, demonstrating the efficacy of LDCT in reducing lung cancer mortality, are reviewed. The potential of liquid biopsy as a complement to LDCT is explored, with a focus on multi-cancer early detection technologies. Notable advances include the Circulating Cell-free Genome Atlas study and the Galleri® test, which have shown promise in detecting cancer at early stages through blood-based screening. We also highlight the challenges and limitations of current screening methods, including the need to improve strategies for screening non-smokers and the importance of balancing benefits against risks. As lung cancer screening continues to advance, combining LDCT and liquid biopsy is anticipated to provide more comprehensive and effective early detection strategies.
本综述探讨了肺癌筛查项目的现状和近期进展,重点关注低剂量计算机断层扫描(LDCT)和新兴的液体活检技术。在韩国,自2019年实施国家肺癌筛查项目以来,已在降低肺癌死亡率方面显示出了令人鼓舞的成果。本综述讨论了韩国的LDCT筛查情况,包括短期死亡率的降低、筛查参与率的提高以及戒烟率的提升。对包括国家肺癌筛查试验、荷兰-鲁汶肺癌筛查研究试验和意大利多中心肺癌检测研究在内的主要国际试验结果进行了综述,这些结果证明了LDCT在降低肺癌死亡率方面的有效性。探讨了液体活检作为LDCT补充手段的潜力,重点关注多癌早期检测技术。显著进展包括循环游离基因组图谱研究和Galleri®检测,它们在通过血液筛查早期检测癌症方面显示出了前景。我们还强调了当前筛查方法的挑战和局限性,包括需要改进针对非吸烟者的筛查策略以及平衡收益与风险的重要性。随着肺癌筛查的不断推进,预计将LDCT和液体活检相结合可提供更全面、有效的早期检测策略。