Lung cancer screening: Clinical practice guidelines in oncology

摘要: Lung cancer screening with LDCT is a complex and controversial topic, inherent risks benefits. Results from the large, prospective, randomized NLST show that lung can decrease cancer–specific mortality by 20% even all-cause 7%.8 The results indicate to prevent one death cancer, 320 high-risk individuals must be screened LDCT. However, findings have not been replicated yet in separate cohort. Further analysis of underway, including comparative effectiveness modeling. cost-effectiveness true benefit-to-risk ratio for still determined. At some point, an acceptable level risk will deemed appropriate benefits screening. The NCCN Cancer Screening Panel recommends helical select patients at high based on results, nonrandomized studies, observational data. These guidelines discuss detail criteria determining which are risk, algorithm provides recommendations evaluating following-up nodules detected (e.g., solid part-solid nodules). Smokers should always encouraged quit smoking tobacco (http://www.smokefree.gov/). Programs using behavioral counseling combined medications promote cessation (approved FDA) very useful (see Treating Tobacco Use Dependence: Quick Reference Guide Clinicians; http://www.surgeongeneral.gov/tobacco/tobaqrg.htm). When considering screening, it important full understanding all related As policies implementing programs designed, focus multidisciplinary (incorporating primary care doctors, pulmonologists, radiologists, thoracic surgeons, medical oncologists, pathologists) helpful optimize decision-making minimize interventions benign disease.