検診された集団における肺がんの発症および死亡の潜在リスクの比較
M Patricia Rivera1, Thad Benefield2, Danielle D Durham2
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Rochester University Medical Center, Rochester, NY; Wilmot Cancer Institute, University of Rochester, Rochester, NY.
Chest
|September 5, 2025
まとめ
肺がんスクリーニング (LCS) を受けている人は,試験参加者と比較して肺がんを発症し死亡するリスクが高くなります. これは,多様な集団におけるLCSの注意深いモニタリングの必要性を強調しています.
科学分野:
- 肺科
- 腫瘍学
- 公衆衛生
背景:
- 肺がんスクリーニング (LCS) 試験の参加者は一般的に一般人よりも健康です.
- 参加者の特徴の違いは,LCSの効果とリスクに影響を与える可能性があります.
- これらの違いを理解することは,現実のLCSの適用に不可欠です.
研究 の 目的:
- レジスタリでLCSを受けた個人と主要なLCS試験の参加者の間で,肺がんを発症し死亡するリスクを比較する.
- LCSの対象となる実際の集団が試験コホートと有意に異なるかどうかを評価する.
主な方法:
- ノースカロライナ肺部スクリーニングレジストリ (NCLSR),行動リスク因子監視システム (BRFSS) 肺がんスクリーニングモジュール,および全国肺部スクリーニング試験 (NLST) のデータを活用した.
- 肺がんの発生率と死亡率の推定5年
- コエンのDを用いたレジストリ集団 (NCLSR,BRFSS) と試験参加者 (NLST) のリスクメトリックの比較
主要な成果:
- レジストリ集団 (NCLSR,BRFSS) は,NLST参加者と比較して,高齢で,COPDと癌歴の割合が高かった.
- BRFSSとNCLSRの集団では,NLSTの参加者よりも5年後の肺がんのリスクの中央値が著しく高かった.
- 検診を受けなかった場合,肺がんで死亡する5年後の確率についても同様のパターンが観察され,NLST参加者の割合は低い.
結論:
- 現実の世界でのLCS集団は,LCS試験参加者よりも高い肺がんリスク因子と発生率/死亡リスクを示しています.
- 似たような喫煙暴露にもかかわらず,レジストリ群の併発症はより多く,LCSの害について懸念を喚起しています.
- レジストリ群のベースラインリスクの上昇は,継続的なLCSモニタリングと評価の重要性を強調しています.
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