Systematic review of baseline low-dose CT lung cancer screening.
ABSTRACT The purpose of this systematic review was to provide physicians and patients with a synthesis of the available data and an assessment of the operating characteristics associated with baseline LDCT screening for lung cancer. Various databases, meeting abstracts, clinical trials in progress, and major textbooks for relevant data from 1966 to 2006 were searched for relevant studies. The median value of sensitivity, specificity, positive predictive value and negative predictive value were 81%, 81%, 8% and 99%, respectively. Of the studies that compared LDCT with other lung cancer screening maneuvers, it was found that LDCT detected a greater number of cancerous nodules. On average, 80% of lung cancers detected by baseline LDCT screening were categorized as Stage I cancers. Current data demonstrate that both the operating characteristics of baseline LDCT screening and the relatively high proportion of Stage I cancers detected with LDCT may potentially lead to effective screening programs. However, evidence of reduced mortality and morbidity with the use of LDCT is not established. Therefore, LDCT for lung cancer screening should be considered as investigative and needs to be confirmed by well-designed randomized controlled trials prior to community and institutional implementation.
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ABSTRACT: Background Lung cancer is the leading cause of cancer-related death, and has become an enormous economic burden in China. Low-dose spiral CT (LDCT) screening can reduce lung cancer mortality. The feasibility of conducting a population-based lung cancer screening with LDCT in China is uncertain. Objectives To describe the mythology of a demonstration program of LDCT lung cancer screening in China. Methods In 2010, a demonstration program of ongoing prospective, multi-centre, population-based Lung cancer screening was initiated in China. High risk individuals are enrolled in a cluster sampling design in each centre. Participants receive baseline screening and annual screening with spiral CT and follow-up information are also all collected. The objective of this program is to evaluate the feasibility of conducting population-based LDCT lung cancer screening in China context. The rates of detection, early diagnosis and treatment are defined as indicators of the program performance. The optimal management strategies for nodules will be explored in the Chinese context based the experiences in other studies overseas. Conclusions This demonstration program will provide opportunities to explore feasibility of LDCT lung cancer screening in the Chinese setting.Thoracic Cancer. 10/2013;
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ABSTRACT: The aim of this paper is to underline the importance of the role of general practitioners (GPs) in distributing vital information about prevention to citizens, to highlight the importance of the so-called voluntary prevention programmes, both for conditions for which no organised screening programmes exist and for those for which they do exist but may well be obsolete or inefficient. Nowadays, voluntary prevention is made more effective thanks to the new sophisticated diagnostic technologies applied worldwide by diagnostic imaging. Epidemiological data about the incidence and causes of death among the Italian population have shown that screening programmes should be aimed first at fighting the following diseases: prostatic carcinoma, lung cancer, colorectal carcinoma, breast cancer, cardiovascular disease, cerebrovascular disease, aortic and peripheral vascular disease. GPs do not generally give good or adequate instructions concerning voluntary prevention programmes; GPs may not even be aware of this type of prevention which could represent a valuable option together with the existing mass screening programmes. Therefore, in the following analysis, we aim to outline the correct diagnostic pathway for the prevention of diseases having the highest incidence in our country and which represent the most frequent causes of death. If used correctly, these screening programmes may contribute to the success of secondary prevention, limiting the use of tertiary prevention and thus producing savings for the Italian National Health System.La radiologia medica 01/2015; · 1.37 Impact Factor
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ABSTRACT: Lung cancer is the most frequent malignant asbestos-related pathology and remains the most fatal cancer of industrialized countries. In heavy smokers, early detection of lung cancer with chest computed tomography (CT) leads to a 20% mortality reduction. However, the use of CT screening for early detection of lung cancer in asbestos-exposed workers requires further investigation. To determine whether CT screening in asbestos-exposed workers is effective in detecting asymptomatic lung cancer using a systematic review and meta-analysis. We reviewed all cohort studies involving chest CT screening in former asbestos-exposed workers. The search strategy used the keywords: "asbestos", "lung cancer", "screening" and "occupation*" or "work". Databases were PubMed, Cochrane Library, Science Direct, Embase. Seven studies matched our inclusion criteria. Baseline screening detected 49 asymptomatic lung cancers among 5074 asbestos-exposed workers. Of the 49 reported prevalences, at least 18 were in the earliest stage (stage 1) accessible to complete removal surgery. The prevalence of all lung cancers detected by CT screening in asbestos-exposed workers was 1.1% (CI 95%: 0.6%-1.8%). CT screening in asbestos-exposed workers is effective in detecting asymptomatic lung cancer. Detection of lung cancer in asbestos-exposed workers using CT is at least equal to the prevalence in heavy smokers (1%; 95%CI: 0.09%-1.1%) (Aberle et al., N Engl J Med, 2011), and also shared a similar proportion of stage 1 diagnoses. Screening asbestos-exposed workers could reduce mortality in proportions previously observed among heavy smokers and thus, should not be neglected, particularly for individuals combining both exposures.Chest 01/2014; · 7.13 Impact Factor