资源描述：
《Screening for Lung Cancer 2013 ACCP》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、CHESTSupplementDIAGNOSISANDMANAGEMENTOFLUNGCANCER,3RDED:ACCPGUIDELINESScreeningforLungCancerDiagnosisandManagementofLungCancer,3rded:AmericanCollegeofChestPhysiciansEvidence-BasedClinicalPracticeGuidelinesFrankC.Detterbeck,MD,FCCP;PeterJ.Mazzone,MD,MPH,FC
2、CP;DavidP.Naidich,MD,FCCP;andPeterB.Bach,MD,FCCPBackground:Lungcancerisbyfarthemajorcauseofcancerdeathslargelybecauseinthemajorityofpatientsitisatanadvancedstageatthetimeitisdiscovered,whencurativetreatmentisnolongerfeasible.Thisarticleexaminesthedatarega
3、rdingtheabilityofscreeningtodecreasethenumberoflungcancerdeaths.Methods:Asystematicreviewwasconductedofcontrolledstudiesthataddresstheeffectivenessofmethodsofscreeningforlungcancer.Results:Severallargerandomizedcontrolledtrials(RCTs),includingarecentone,h
4、avedemon-stratedthatscreeningforlungcancerusingachestradiographdoesnotreducethenumberofdeathsfromlungcancer.OnelargeRCTinvolvinglow-doseCT(LDCT)screeningdemonstratedasignificantreductioninlungcancerdeaths,withfewharmstoindividualsatelevatedriskwhendoneinth
5、econtextofastructuredprogramofselection,screening,evaluation,andmanagementoftherelativelyhighnumberofbenignabnormalities.WhetherotherRCTsinvolvingLDCTscreeningareconsistentisunclearbecausedataarelimitedornotyetmature.Conclusions:Screeningisacomplexinterpl
6、ayofselection(apopulationwithsufficientriskandfewseriouscomorbidities),thevalueofthescreeningtest,theintervalbetweenscreeningtests,theavailabilityofeffectivetreatment,theriskofcomplicationsorharmsasaresultofscreening,andthedegreewithwhichthescreenedindivid
7、ualscomplywithscreeningandtreatmentrecom-mendations.ScreeningwithLDCTofappropriateindividualsinthecontextofastructuredprocessisassociatedwithasignificantreductioninthenumberoflungcancerdeathsinthescreenedpopulation.Giventhecomplexinterplayoffactorsinherent
8、inscreening,manyques-tionsremainonhowtoeffectivelyimplementscreeningonabroaderscale.CHEST2013;143(5)(Suppl):e78S–e92SAbbreviations:ACCP5AmericanCollegeofChestPhysicians;CXR5chestradiograph;DANTE5DetectionandScreenin
