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肺癌查:美国预防服务工作组建议声明
, Alex H Krist1,2, Karina W Davidson3
1Fairfax Family Practice Residency, Fairfax, Virginia.
JAMA
|March 9, 2021
概括
建议每年对50至80岁的高风险成年人进行低剂量CT扫描的肺癌查. 这种查在有明显吸烟史的个体中为早期检测提供了适度的净益.
科学领域:
- 肺病学
- 癌症学
- 预防医学
背景情况:
- 肺癌是美国癌症死亡的主要原因之一,
- 早期肺癌的预后比晚期更好,
- 美国预防服务工作组 (USPSTF) 在2013年更新了其建议.
研究的目的:
- 更新2013年USPSTF关于肺癌查的建议.
- 评估低剂量计算机断层扫描 (LDCT) 的准确性,益处和危害.
- 使用建模研究确定最佳查年龄,间隔和策略.
主要方法:
- 对LDCT查准确性,益处和危害进行了系统审查.
- 一项合作建模研究为选参数做出了明智的决定.
- 研究群体包括50至80岁的成年人,有20包年吸烟史 (目前或前15年吸烟者).
主要成果:
- 年度LDCT查显示,高风险个体的净收益中等.
- 风险评估考虑年龄,吸烟史 (包装年) 和戒烟后的时间.
- 对于查的好处,USPSTF的结论是中等的.
结论:
- USPSTF建议每年对50至80岁的成年人进行LDCT肺癌查,并且有20包年吸烟史.
- 如果吸烟者已经戒烟15年,或患有限制预期寿命或手术选择的疾病,则应停止查.
- 与2013年指南相比,这一更新的建议降低了开始年龄和包装年限.
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