Lung cancer is the leading cause of cancer-related deaths in China,with over 690000 lung cancer deaths estimated in 2018.The mortality has increased about five-fold from the mid-1970s to the 2000s.Lung cancer lowdose ...Lung cancer is the leading cause of cancer-related deaths in China,with over 690000 lung cancer deaths estimated in 2018.The mortality has increased about five-fold from the mid-1970s to the 2000s.Lung cancer lowdose computerized tomography(LDCT)screening in smokers was shown to improve survival in the US National Lung Screening Trial,and more recently in the European NELSON trial.However,although the predominant risk factor,smoking contributes to a lower fraction of lung cancers in China than in the UK and USA.Therefore,it is necessary to establish Chinese-specific screening strategies.There have been 23 associated programmes completed or still ongoing in China since the 1980s,mainly after 2000;and one has recently been planned.Generally,their entry criteria are not smoking-stringent.Most of the Chinese programmes have reported preliminary results only,which demonstrated a different high-risk subpopulation of lung cancer in China.Evidence concerning LDCT screening implementation is based on results of randomized controlled trials outside China.LDCT screening programmes combining tobacco control would produce more benefits.Population recruitment(e.g.risk-based selection),screening protocol,nodule management and costeffectiveness are discussed in detail.In China,the high-risk subpopulation eligible for lung cancer screening has not as yet been confirmed,as all the risk parameters have not as yet been determined.Although evidence on best practice for implementation of lung cancer screening has been accumulating in other countries,further research in China is urgently required,as China is now facing a lung cancer epidemic.展开更多
基金We give our special appreciation to Robert Carlton for proofreading the manuscript.YIC is funded by China Scholarship Council(CSC201706240094)West China-Liverpool Clinician-Scientist Leadership Scholarship.MPAD is funded by the Roy Castle Lung Cancer Foundation+3 种基金This work is also supported by 1.3.5 Project for Disciplines of Excellence,West China Hospital.Sichuan University(ZYJC18001)the National Key Development Plan for Precision Medicine Research(2017YFC0910004)the Transformation Projects of Sci-Tech Achievements of Sichuan Province(2016CZYD0001)the Sci-Tech Support Program of Science and Technology Department of Sichuan Province(2016SZ0073).
文摘Lung cancer is the leading cause of cancer-related deaths in China,with over 690000 lung cancer deaths estimated in 2018.The mortality has increased about five-fold from the mid-1970s to the 2000s.Lung cancer lowdose computerized tomography(LDCT)screening in smokers was shown to improve survival in the US National Lung Screening Trial,and more recently in the European NELSON trial.However,although the predominant risk factor,smoking contributes to a lower fraction of lung cancers in China than in the UK and USA.Therefore,it is necessary to establish Chinese-specific screening strategies.There have been 23 associated programmes completed or still ongoing in China since the 1980s,mainly after 2000;and one has recently been planned.Generally,their entry criteria are not smoking-stringent.Most of the Chinese programmes have reported preliminary results only,which demonstrated a different high-risk subpopulation of lung cancer in China.Evidence concerning LDCT screening implementation is based on results of randomized controlled trials outside China.LDCT screening programmes combining tobacco control would produce more benefits.Population recruitment(e.g.risk-based selection),screening protocol,nodule management and costeffectiveness are discussed in detail.In China,the high-risk subpopulation eligible for lung cancer screening has not as yet been confirmed,as all the risk parameters have not as yet been determined.Although evidence on best practice for implementation of lung cancer screening has been accumulating in other countries,further research in China is urgently required,as China is now facing a lung cancer epidemic.
