Lancet Oncol:肺癌高风险一定要每年筛查吗?

2016-03-23 MedSci MedSci原创

杜克大学癌症研究所进行的一项研究表明,大多数肺癌高危人群,如果在首次进行低剂量CT(LDCT)筛查时没有发现肺癌,那么之后不需要每年都进行LDCT筛查。就算是重度吸烟者,首次LDCT筛查阴性,也没有必要每年筛查。研究结果发表在近期的The Lancet Oncology。Patz和同事对国家肺癌筛查试验(大型前瞻性研究,将先前吸烟者随机分为3次每年一次的LDCT或胸片,进行肺癌的早期检测)中的数据

杜克大学癌症研究所进行的一项研究表明,大多数肺癌高危人群,如果在首次进行低剂量CT(LDCT)筛查时没有发现肺癌,那么之后不需要每年都进行LDCT筛查。就算是重度吸烟者,首次LDCT筛查阴性,也没有必要每年筛查。研究结果发表在近期的The Lancet Oncology。

Patz和同事对国家肺癌筛查试验(大型前瞻性研究,将先前吸烟者随机分为3次每年一次的LDCT或胸片,进行肺癌的早期检测)中的数据进行了分析。所有参与者年龄在55-74岁,曾吸烟差不多30年(包括每天一包,持续30年;每天2包,持续15年等)。

最初19,066名LDCT筛查阴性的人群中,444(2%)名参与者在最后的随访中诊断为肺癌。在阴性筛查结果后第一年和第一次年度筛查之前,有17(占最初LDCT阴性结果人群的0.09%)名患者诊断为肺癌。还有75名(0.4%)参与者在第一次和第二次年度筛查间诊断为肺癌。第一次年度筛查和基线筛查比较,肺癌发生率分别为0.34%和1%。研究者认为,初次筛查阴性后,不进行第一次年度筛查,最多只会增加28例肺癌死亡 (186 vs. 212/100,000人年)。

Patz说:“我们的分析显示,对于初次筛查阴性的人群,没有必要再进行年度筛查,以后还要结合风险预测和经济效益模型,改进肺癌筛查指南。”

他还说,国家癌症筛查试验中,在这7年研究期间,LDCT的假阳性结果高达40%。改善LDCT筛查肺癌的精确性可以显著减少需要年度筛查的数据。

原始出处:


Edward F Patz Jr,et al. Lung cancer incidence and mortality in National Lung Screening Trial participants who underwent low-dose CT prevalence screening: a retrospective cohort analysis of a randomised, multicentre, diagnostic screening trial. The Lancet Oncology. 18 March 2016.

High-risk lung cancer patients may not need annual screenings.EurekAlert.21-Mar-2016


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    2016-07-03 minlingfeng
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    2016-09-03 doctorJiangchao

    继续学习

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    2016-09-03 doctorJiangchao

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    2016-04-14 howi

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