Taylor W F, Fontana R S, Uhlenhopp M A, Davis C S
Cancer. 1981 Mar 1;47(5 Suppl):1114-20. doi: 10.1002/1097-0142(19810301)47:5+<1114::aid-cncr2820471309>3.0.co;2-n.
Screening for lung cancer is somewhat controversial in that very few evaluations of the screening process have been made, and even fewer have involved the use of concomitant, unscreened controls. This report of the Mayo Lung Project provides evaluation of a randomly selected 4500 clinic patients, offered screening for lung cancer at four-month intervals for six years. Another 4500 randomly selected controls not offered screening were merely observed. Good screening is defined, the Mayo project is evaluated, and puzzling results are presented and discussed. From the screened group, 98 new cases of lung cancer have been detected, 67 by study screening and 31 by spontaneous reporting of symptoms (15) or by x-ray examinations (16) done in other than study circumstances. From the controls, 64 new lung cancer cases have been detected, 43 by symptoms and 1 by other methods. Lung cancer mortality is 39 for study patients and 41 for controls. There is thus no evidence at this time that early case finding hs decreased mortality from lung cancer.
肺癌筛查存在一定争议,因为对筛查过程的评估很少,涉及同时使用未筛查对照的评估更少。梅奥肺癌项目的这份报告对随机挑选的4500名门诊患者进行了评估,这些患者每四个月接受一次肺癌筛查,为期六年。另外随机挑选的4500名未接受筛查的对照仅进行观察。定义了良好筛查,对梅奥项目进行了评估,并呈现和讨论了令人困惑的结果。在筛查组中,已检测出98例新的肺癌病例,67例通过研究筛查发现,31例通过在研究环境之外出现症状(15例)或进行X光检查(16例)后自发报告发现。在对照组中,已检测出64例新的肺癌病例,43例通过症状发现,1例通过其他方法发现。研究患者的肺癌死亡率为39,对照组为41。因此,目前没有证据表明早期发现病例降低了肺癌死亡率。