Yau G, Lock M, Rodrigues GSystematic review of baseline low-dose CT lung cancer screening. Lung Cancer 58: 161-170
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.
[Show abstract] [Hide abstract] 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.0Comments 1Citation
- "Recently, low-dose computed tomography (LDCT) has been proposed for the screening of lung cancer. The values reported in the literature up to 2006 concerning the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of LDCT are 81, 81, 8 and 99 %, respectively,  depending on the single research taken into consideration. According to other more recent studies, the sensitivity and specificity values are 87.7 and 99.3 %, respectively  ; in the NELSON study these values seem to be even higher with 99 % for sensitivity, 98 % for specificity, 39 % for PPV and 97.4 % for NPV. "
[Show abstract] [Hide abstract] ABSTRACT: To take lung cancer screening into national programmes, we first have to answer the question whether low-dose computed tomography (LDCT) screening and treatment of early lesions will decrease lung cancer mortality compared with a control group, to accurately estimate the balance of benefits and harms, and to determine the cost-effectiveness of the intervention.0Comments 41Citations
- "LDCT ¼ low-dose computed tomography; ND ¼ not determined; PKS ¼ pack years; PYS ¼ pack-years. Table is adapted from Rossi et al (2005) and Yau et al (2007). "
- 0Comments 12Citations