中国肺癌低剂量CT筛查指南(2023年版)

China National Lung Cancer Screening Guideline with Low-dose Computed Tomography(2023 Version)

肺癌是导致中国癌症死亡的首要原因。近年来低剂量计算机断层扫描(low-dose computed tomography,LDCT)筛查的效果进一步被证实,并且在高危人群选择、筛查间隔及结节管理的研究方面取得了显著进展。本研究的目的是对2018年中国肺癌LDCT筛查指南进行修订。由国家卫健委任命的中国肺癌早诊早治专家组专家及中国西部肺癌研究协作中心部分专家,共同参与了2023版中国肺癌筛查指南的修订工作。专家们根据近年来国内外LDCT肺癌筛查进展,结合我国肺癌流行病学特征,共同修订了本次肺癌筛查指南。本指南对以下方面进行了修订:(1)高危人群定义中考虑了除吸烟外其他肺癌危险因素;(2)对LDCT扫描参数进行了修改和补充;(3)扩大了部分筛查阴性个体的筛查间隔;(4)将部分阳性结节的随访时间由3个月调整为6个月;(5)强调了多学科诊疗(multi-disciplinary treatment,MDT)在阳性结节管理、肺癌诊断和治疗中的作用。本次修订将使得LDCT筛查指南更适应我国国情,并使筛查、干预与治疗路径更为明确。未来应进一步基于新兴技术,包括生物标志物及人工智能研究,优化肺癌LDCT筛查方法及技术。

Lung cancer is the leading cause of cancer-related death in China.The effectiveness of low-dose computed tomography(LDCT)screening has been further validated in recent years,and significant progress has been made in research on identifying high-risk individuals,personalizing screening interval,and management of screen-detected findings.The aim of this study is to revise China national lung cancer screening guideline with LDCT(2018 version).The China Lung Cancer Early Detection and Treatment Expert Group(CLCEDTEG)designated by the China’s National Health Commission,and China Lung Oncolgy Group experts,jointly participated in the revision of Chinese lung cancer screening guideline(2023 version).This revision is based on the recent advances in LDCT lung cancer screening at home and abroad,and the epidemiology of lung cancer in China.The following aspects of the guideline were revised:(1)lung cancer risk factors besides smoking were considered for the identification of high risk population;(2)LDCT scan parameters were further classified;(3)longer screening interval is recommended for individuals who had negative LDCT screening results for two consecutive rounds;(4)the follow-up interval for positive nodules was extended from 3months to 6 months;(5)the role of multi-disciplinary treatment(MDT)in the management of positive nodules,diagnosis and treatment of lung cancer were emphasized.This revision clarifies the screening,intervention and treatment pathways,making the LDCT screening guideline more appropriate for China.Future researches based on emerging technologies,including biomarkers and artificial intelligence,are needed to optimize LDCT screening in China in the future.