风险调整的肺癌查 开始的年龄 对于前吸烟者
Clara Frick1,2, Lára R Hallsson3, Uwe Siebert3,4,5,6,7,8
1Division of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.
JAMA network open
|February 3, 2026
概括
肺癌查可以为前吸烟者个性化. 根据戒烟以来的时间,根据风险适应的开始年龄,可以优化对有重度吸烟史的个体的查.
科学领域:
- 在瘤学瘤学.
- 预防医学 预防医学
- 流行病学 流行病学
背景情况:
- 美国预防服务特别工作组 (USPSTF) 建议对50至80岁的个人进行肺癌查,其吸烟史≥20包年,戒烟历史≤15年.
- 目前的指导方针可能无法充分个性化对前吸烟者的查,基于他们个人风险概况与戒烟以来的时间相关.
研究的目的:
- 制定个性化肺癌查策略,通过定义风险适应的开始年龄,根据戒烟以来的时间进行查.
- 改进前重度吸烟者肺癌查建议.
主要方法:
- 一项使用英国生物库 (n=86,035) 纵向数据的队列研究.
- 分析包括50岁以上的前任或现任大吸烟者 (≥20包年) .
- 多变量扩展的考克斯比例危险模型评估了戒烟时间,包装年,年龄和10年肺癌发病率之间的关联.
主要成果:
- 该研究确定了戒烟的风险推迟期 (RPP).
- 根据戒烟后的时间,RPP显著变化:2.7年 (≤5年),6.2年 (6-10年),10.4年 (11-15年) 和17.1年 (>15年).
- 根据风险调整的查开始年龄可能在53岁至67岁之间,相比之下,USPSTF对目前吸烟者的建议年龄为50岁.
结论:
- 这项英国生物银行研究为前重度吸烟者的风险适应性肺癌查开始年龄提供了经验基础.
- 根据自戒烟以来的时间来个性化查启动可以更好地与个体肺癌风险保持一致.
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