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Contemporary issues in the implementation of lung cancer screening

机译：肺癌筛查实施中的当代问题

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Lung cancer screening with low-dose computed tomography can reduce death from lung cancer by 20–24% in high-risk smokers. National lung cancer screening programmes have been implemented in the USA and Korea and are being implemented in Europe, Canada and other countries. Lung cancer screening is a process, not a test. It requires an organised programmatic approach to replicate the lung cancer mortality reduction and safety of pivotal clinical trials. Cost-effectiveness of a screening programme is strongly influenced by screening sensitivity and specificity, age to stop screening, integration of smoking cessation intervention for current smokers, screening uptake, nodule management and treatment costs. Appropriate management of screen-detected lung nodules has significant implications for healthcare resource utilisation and minimising harm from radiation exposure related to imaging studies, invasive procedures and clinically significant distress. This review focuses on selected contemporary issues in the path to implement a cost-effective lung cancer screening at the population level. The future impact of emerging technologies such as deep learning and biomarkers are also discussed.
机译：用低剂量计算断层扫描的肺癌筛查可以将肺癌的死亡降低20-24％，高危吸烟者。国家肺癌筛查计划已在美国和韩国实施，正在欧洲，加拿大等国家实施。肺癌筛查是一种过程，不是测试。它需要一个有组织的编程方法来复制肺癌死亡率降低和枢轴临床试验的安全性。筛选程序的成本效益受到筛查敏感性和特异性的强烈影响，即时阻止筛查，对当前吸烟者进行吸烟停止干预的整合，筛选吸收，结节管理和治疗成本。筛选的肺结节的适当管理对医疗资源利用率具有显着影响，并最大限度地减少与成像研究，侵入性程序和临床显着的痛苦相关的辐射暴露的危害。本综述重点介绍了在人口层面实施具有成本效益的肺癌筛查的途径中所选的当代问题。还讨论了深入学习和生物标志物等新兴技术的未来影响。

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