现在是肺癌查的好时机:系统审查和生存元分析
Eliana E Kim1, Irena Cenzer1, Francis J Graham2
1Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California.
American journal of preventive medicine
|May 30, 2025
概括
低剂量计算机断层扫描 (LDCT) 的肺癌查可以在2.2至5.2年后预防1例死亡,这取决于查的人数. 这表明LDCT对高风险人群最有利,预期寿命超过3.4年.
科学领域:
- 医学查 医学查
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
背景情况:
- 低剂量计算机断层扫描 (LDCT) 的肺癌查提供了长期的死亡率降低,但涉及到即时的风险.
- 目前的指导方针建议对预期寿命超过受益时间的个人进行查.
- 估计这种受益时间对于优化查协议至关重要.
研究的目的:
- 估计肺癌查在预防肺癌死亡率方面所带来的好处时间.
- 为了为临床指导方针提供有关个人查适当持续时间的信息.
主要方法:
- 对肺癌查LDCT的八项随机对照试验 (N=88,526) 的系统综述和元分析.
- 维布尔生存曲线和马尔科夫链蒙特卡罗模拟,以估计随时间推移的绝对风险降低 (ARR).
- 获得福利的时间定义为达到0.0005,0.001和0.002.002的ARR值的时间.
主要成果:
- 在每1000名接受查的人群中,在3.4年后可以预防1例肺癌死亡 (ARR=0.001).
- 预防每2000名接受查的人中的一例死亡 (ARR=0.0005) 需要2.2年;预防每500名接受查的人中的一例死亡 (ARR=0.002) 需要5.2年.
- 查的有效性因参与者的数量和受益的时间而异.
结论:
- 肺癌查最适合于高风险的老年人,预期寿命超过3.4年.
- 估计的受益时间支持LDCT肺癌查的长期性质.
- 对预期寿命的个性化评估对于确定查资格至关重要.
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