Lung cancer screening in never-smokers: facts and remaining issues

[摘要] The final publication of the NELSON trial data [1] has corroborated the findings of the National Lung Screening Trial (NLST) confirming the ability of lung cancer screening with low-dose computed tomography (LDCT) to detect lung cancer at an early stage and significantly reduce lung cancer mortality in high-risk groups [2]. Since then, the European Respiratory Society and the European Society for Radiology have agreed that Europe’s healthcare systems should allow citizens at risk to benefit from organised pathways to early diagnosis of lung cancer [3] and efforts are ongoing to obtain governmental approval for publicly funded screening programmes in European countries, as has already happened in the USA. However, the mortality benefit of LDCT screening was only demonstrated in heavy smokers in an age range above 50 or 55 years, and in Western countries, where lung cancer in never-smokers is 12–30 times less frequent than in smokers [4]. Unfortunately, lung cancer in never-smokers has been steadily increasing worldwide in the past few decades and it now ranks seventh among the causes of cancer death [5–7]. It has a particularly high impact in Asia, where it peaks as high as 39.7% of all lung cancer patients in China, and at 38% in South Korea, compared to only 10%–15% in Europe and North America.

[学科分类] 呼吸医学