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《Screening for Lung Cancer 2013 ACCP》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫(kù)。
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)screeningdemonstratedasigni?cantreductioninlungcancerdeaths,withfewharmstoindividualsatelevatedriskwhendoneinth
5、econtextofastructuredprogramofselection,screening,evaluation,andmanagementoftherelativelyhighnumberofbenignabnormalities.WhetherotherRCTsinvolvingLDCTscreeningareconsistentisunclearbecausedataarelimitedornotyetmature.Conclusions:Screeningisacomplexinterpl
6、ayofselection(apopulationwithsuf?cientriskandfewseriouscomorbidities),thevalueofthescreeningtest,theintervalbetweenscreeningtests,theavailabilityofeffectivetreatment,theriskofcomplicationsorharmsasaresultofscreening,andthedegreewithwhichthescreenedindivid
7、ualscomplywithscreeningandtreatmentrecom-mendations.ScreeningwithLDCTofappropriateindividualsinthecontextofastructuredprocessisassociatedwithasigni?cantreductioninthenumberoflungcancerdeathsinthescreenedpopulation.Giventhecomplexinterplayoffactorsinherent
8、inscreening,manyques-tionsremainonhowtoeffectivelyimplementscreeningonabroaderscale.CHEST2013;143(5)(Suppl):e78S–e92SAbbreviations:ACCP5AmericanCollegeofChestPhysicians;CXR5chestradiograph;DANTE5DetectionandScreenin
