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Abstract
Background Lung cancer is the second most common and the most fatal form of cancer. Although annual low-dose computed tomography is used as the primary method of cancer screening, it presents challenges regarding resources as well as potential health risks from radiation exposure. Chest radiography (CXR), though less effective, is used frequently and commonly. Moreover, often in clinical settings, CXR is the first imaging modality used; computed tomography is subsequently performed if abnormalities are detected on CXRs. This study examined whether controlling for distractors and time constraints, as well as side-by-side comparison of multiple CXRs in clinical settings can aid earlier detection of radiological abnormalities indicative of lung cancer lesions. Methods Thirty-two attending physicians in the Republic of Korea examined 1,750 radiographs of 50 lung cancer cases. Using “hot spot” technology, participants indicated the possible locations of cancer lesions on each radiograph. Subsequently, the same radiographs, cropped to focus the anatomical regions where lung cancers were diagnosed, were shown side-by-side to the participants. The participants were asked to identify the radiograph which first enabled the diagnosis of lung cancer and which first showed a possible lesion. Results Removal of systemic constraints alone significantly improved lesion identification by 221.72±9.69 days. Presenting radiographs side-by-side, cropped to relevant areas, had an additional significant and positive impact on cancer detection in both hidden and open areas on CXRs. Also, lesions were detected at smaller sizes and earlier than when actually diagnosed. Conclusions CXR with improved methods and settings provides an easily accessible and low-risk imaging method for earlier detection of lung cancer compared to current clinical imaging settings. Further, this study demonstrates the potential effectiveness of programs that allow side-by-side comparisons of cropped areas of multiple radiographs to detect radiological abnormalities.
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Affiliation(s)
- Junghyun Kim
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
| | - Kwan Hyoung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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2
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Cai P, Su D, Yang W, He Z, Zhang C, Liu H, Liu Z, Zhang X, Gao L, Liu Y, Jiang H, Gao F, Gao X. Inherently PET/CT Dual Modality Imaging Lipid Nanocapsules for Early Detection of Orthotopic Lung Tumors. ACS APPLIED BIO MATERIALS 2020; 3:611-621. [DOI: 10.1021/acsabm.9b00993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Pengju Cai
- Department of Chemistry and Chemical Engineering, Beijing University of Technology, Beijing, 100124, P. R. China
| | - Dongdong Su
- Department of Chemistry and Chemical Engineering, Beijing University of Technology, Beijing, 100124, P. R. China
| | | | | | - Chunyu Zhang
- Department of Chemistry and Chemical Engineering, Beijing University of Technology, Beijing, 100124, P. R. China
| | - Hui Liu
- Beijing National Laboratory for Molecular Sciences, Radiochemistry and Radiation Chemistry Key Laboratory of Fundamental Science, College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, P. R. China
| | - Zhibo Liu
- Beijing National Laboratory for Molecular Sciences, Radiochemistry and Radiation Chemistry Key Laboratory of Fundamental Science, College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, P. R. China
| | | | - Liang Gao
- Department of Chemistry and Chemical Engineering, Beijing University of Technology, Beijing, 100124, P. R. China
| | | | - Huaidong Jiang
- School of Physical Science and Technology, Shanghai Tech University, Shanghai 201210, China
| | | | - Xueyun Gao
- Department of Chemistry and Chemical Engineering, Beijing University of Technology, Beijing, 100124, P. R. China
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3
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Wu F, Wang H, Tao H, Huang H, Zhang L, Wu D, Wan Y. Comparison of value of biomarkers in diagnosing lung cancer: An overview of systematic reviews protocol. Medicine (Baltimore) 2019; 98:e15525. [PMID: 31083197 PMCID: PMC6531075 DOI: 10.1097/md.0000000000015525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In both sexes combined, lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death. Furthermore, the incidence rate is increasing in many countries. Many lung cancer patients have a poor prognosis because they are usually diagnosed at an advanced stage. Therefore, there is an urgent need to develop effective methods for early diagnosis of lung cancer. Some systematic reviews have evaluated the value of biomarkers for diagnosing lung cancer. However, it remains unclear which biomarker has superior performance for early and accurate detection of lung cancer. This overview aims to assess the methodological and reporting quality of available systematic reviews and to find an optimal biomarker for diagnosing lung cancer. METHODS We searched PubMed, Embase.com, the Cochrane Library of Systematic Reviews, and Web of Science to identify relevant systematic reviews including randomized controlled trials, cross-sectional studies, case-control studies, or cohort studies that reported the value of biomarkers for diagnosing lung cancer. The methodological quality will be assessed using AMASAR-2 checklist, and the reporting quality will be assessed using PRISMA-DTA checklist. Bubble plot will be generated to map the biomarkers, methodological and reporting quality. The pairwise meta-analysis and indirect comparisons will be performed using STATA 13.0. RESULTS The results of this study will be published in a peer-reviewed journal CONCLUSION:: This overview will provide comprehensive evidence of different biomarkers for the diagnosis of lung cancer. ETHICS AND DISSEMINATION Ethics approval and patient consent are not required as this study is an overview based on published systematic reviews.
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Affiliation(s)
- Fanqi Wu
- Department of Respiratory, Lanzhou University Second Hospital
| | - Hong Wang
- Department of Respiratory, Lanzhou University Second Hospital
| | - Hongyan Tao
- Department of Respiratory, Lanzhou University Second Hospital
| | - Huirong Huang
- Department of Respiratory, Lanzhou University Second Hospital
| | - Longguo Zhang
- The Second Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Di Wu
- The Second Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Yixin Wan
- Department of Respiratory, Lanzhou University Second Hospital
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Tuo L, Sha S, Huayu Z, Du K. P16 INK4a gene promoter methylation as a biomarker for the diagnosis of non-small cell lung cancer: An updated meta-analysis. Thorac Cancer 2018; 9:1032-1040. [PMID: 29927090 PMCID: PMC6068431 DOI: 10.1111/1759-7714.12783] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/14/2018] [Accepted: 05/14/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND This meta-analysis was conducted to investigate the diagnostic performance of P16INK4a gene promoter methylation as a biomarker of non-small cell lung cancer (NSCLC). METHODS Two reviewers independently searched the Web of Science, PubMed, Cochrane, Embase, China National Knowledge Infrastructure, and Chinese Biomedical Literature databases. Publications relevant to P16INK4a gene promoter methylation in serum or bronchoalveolar fluid/sputum were screened and included in this meta-analysis. Pooled diagnostic sensitivity, specificity, and symmetric receiver operating characteristic curve were calculated. RESULTS Twenty-six publications with 1768 lung cancer cases and 1323 controls were included. The pooled sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio were 0.46 (95% confidence interval [CI] 0.43-0.48), 0.90 (95% CI 0.88-0.91), 6.33 (95% CI 3.89-10.30), 0.57 (95% CI 0.50-0.65) and 10.72 (95% CI 6.94-16.56), respectively, for P16INK4a gene promoter methylation as a biomarker for the diagnosis of NSCLC. The area under the symmetric receiver operating characteristic curve was 0.75 with a standard error of 0.004. No publication bias was detected via line regression test (t = 0.95; P = 0.35) and Begg's funnel plot. CONCLUSION P16INK4a gene promoter methylation detection in serum or bronchoalveolar fluid/sputum may be a potential biomarker for NSCLC diagnosis; however, the sensitivity was relatively low, which is not suitable for NSCLC screening.
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Affiliation(s)
- Lei Tuo
- Department of Thoracic and Cardiovascular SurgeryWeifang Yidu Central Hospital QingzhouWeifangChina
| | - Sha Sha
- Department of Thoracic and Cardiovascular SurgeryWeifang Yidu Central Hospital QingzhouWeifangChina
| | - Zhang Huayu
- Department of Spine and TraumaWeifang Yidu Central Hospital QingzhouWeifangChina
| | - Ke Du
- Department of Thoracic SurgeryLiaocheng People's Hospital Liaocheng Clinical School of Taishan Medical UniversityLiaochengChina
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5
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Santana-Rodríguez N, Martel E, Clavo B, Llontop P, Calderón-Murgas C, Raad WN, Alshehri K, Ayub A, Jenny Huang CY, Hussein M, Alayón S, Bhora FY. Oncological resection of lung cancer invading the aortic arch In full thickness using a non-fenestrated endograft. J Surg Oncol 2016; 114:412-5. [PMID: 27546105 DOI: 10.1002/jso.24359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/16/2016] [Indexed: 11/05/2022]
Abstract
T4 lung cancer invading the full thickness of the aortic arch was completely removed in a 78-year-old lady using a non-fenestrated endograft closing the left subclavian artery origin without performing surgical revascularization. Left thoracotomy and upper lobectomy with resection of superior segment of the lower lobe and full thickness of the infiltrated aorta was performed without covering the aortic defect. The margins of the specimen were free of tumor. The patient survived 32 months. J. Surg. Oncol. 2016;114:412-415. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Norberto Santana-Rodríguez
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York.,Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Efrén Martel
- Department of Vascular Surgery, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Bernardino Clavo
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain.,Department of Radiation Oncology, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Pedro Llontop
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | | | - Wissam N Raad
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York.,Icahn School of Medicine, New York, New York
| | - Khalid Alshehri
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York
| | - Adil Ayub
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York
| | | | - Mohamed Hussein
- Department of Thoracic Surgery, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Santiago Alayón
- Department of Radiology, Hospital San Roque, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Faiz Y Bhora
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York.,Icahn School of Medicine, New York, New York
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6
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Campomenosi P, Gini E, Noonan DM, Poli A, D'Antona P, Rotolo N, Dominioni L, Imperatori A. A comparison between quantitative PCR and droplet digital PCR technologies for circulating microRNA quantification in human lung cancer. BMC Biotechnol 2016; 16:60. [PMID: 27538962 PMCID: PMC4991011 DOI: 10.1186/s12896-016-0292-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 08/13/2016] [Indexed: 12/18/2022] Open
Abstract
Background Selected microRNAs (miRNAs) that are abnormally expressed in the serum of patients with lung cancer have recently been proposed as biomarkers of this disease. The measurement of circulating miRNAs, however, requires a highly reliable quantification method. Quantitative real-time PCR (qPCR) is the most commonly used method, but it lacks reliable endogenous reference miRNAs for normalization of results in biofluids. When used in absolute quantification, it must rely on the use of external calibrators. Droplet digital PCR (ddPCR) is a recently introduced technology that overcomes the normalization issue and may facilitate miRNA measurement. Here we compared the performance of absolute qPCR and ddPCR techniques for quantifying selected miRNAs in the serum. Results In the first experiment, three miRNAs, proposed in the literature as lung cancer biomarkers (miR-21, miR-126 and let-7a), were analyzed in a set of 15 human serum samples. Four independent qPCR and four independent ddPCR amplifications were done on the same samples and used to estimate the precision and correlation of miRNA measurements obtained with the two techniques. The precision of the two methods was evaluated by calculating the Coefficient of Variation (CV) of the four independent measurements obtained with each technique. The CV was similar or smaller in ddPCR than in qPCR for all miRNAs tested, and was significantly smaller for let-7a (p = 0.028). Linear regression analysis of the miRNA values obtained with qPCR and ddPCR showed strong correlation (p < 0.001). To validate the correlation obtained with the two techniques in the first experiment, in a second experiment the same miRNAs were measured in a larger cohort (70 human serum samples) by both qPCR and ddPCR. The correlation of miRNA analyses with the two methods was significant for all three miRNAs. Moreover, in our experiments the ddPCR technique had higher throughput than qPCR, at a similar cost-per-sample. Conclusions Analyses of serum miRNAs performed with qPCR and ddPCR were largely concordant. Both qPCR and ddPCR can reliably be used to quantify circulating miRNAs, however, ddPCR revealed similar or greater precision and higher throughput of analysis. Electronic supplementary material The online version of this article (doi:10.1186/s12896-016-0292-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paola Campomenosi
- Department of Biotechnology and Life Sciences (DBSV) and "The Protein Factory", University of Insubria, Via JH Dunant, 3, 21100, Varese, Italy. .,The Protein Factory, Centro Interuniversitario di Ricerca in Biotecnologie Proteiche, Politecnico di Milano, ICRM-CNR Milano and University of Insubria, Varese, Italy.
| | - Elisabetta Gini
- Department of Biotechnology and Life Sciences (DBSV) and "The Protein Factory", University of Insubria, Via JH Dunant, 3, 21100, Varese, Italy.,Department of Surgical Sciences and Human Morphology, DSCM, University of Insubria, Via Guicciardini, 9, 21100, Varese, Italy
| | - Douglas M Noonan
- Department of Biotechnology and Life Sciences (DBSV) and "The Protein Factory", University of Insubria, Via JH Dunant, 3, 21100, Varese, Italy.,Scientific and Technological Pole, IRCCS MultiMedica, Milan, Italy
| | - Albino Poli
- Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Paola D'Antona
- Department of Biotechnology and Life Sciences (DBSV) and "The Protein Factory", University of Insubria, Via JH Dunant, 3, 21100, Varese, Italy.,Department of Surgical Sciences and Human Morphology, DSCM, University of Insubria, Via Guicciardini, 9, 21100, Varese, Italy
| | - Nicola Rotolo
- Department of Surgical Sciences and Human Morphology, DSCM, University of Insubria, Via Guicciardini, 9, 21100, Varese, Italy
| | - Lorenzo Dominioni
- Department of Surgical Sciences and Human Morphology, DSCM, University of Insubria, Via Guicciardini, 9, 21100, Varese, Italy
| | - Andrea Imperatori
- Department of Surgical Sciences and Human Morphology, DSCM, University of Insubria, Via Guicciardini, 9, 21100, Varese, Italy
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Sposato B, Lenzi PA, Carelli MR. Could cigarette packaging be used as a tool to make prevention of smoke-induced respiratory diseases? Med Hypotheses 2015; 85:962-4. [PMID: 26364042 DOI: 10.1016/j.mehy.2015.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 08/30/2015] [Indexed: 11/23/2022]
Abstract
The most important consequences of smoking are chronic obstructive pulmonary disease (COPD) and lung cancer (LC). Although the use of shocking images and warning messages on cigarette packaging is a valid tool of smoke dishabituation, unfortunately, millions of people go on smoking. Our hypotheses is that cigarette packet covers could also be used to give further messages, especially meant to spur also a screening of smoke-induced respiratory diseases. Messages on cigarette packaging suggesting smokers to perform a spirometry and a chest X-ray may persuade them not only to quit their habit but also to have a screening for COPD and LC prevention. If our hypotheses is taken into account it will have a strong worldwide impact.
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Affiliation(s)
- Bruno Sposato
- Pneumology Department, "Misericordia" Hospital, Grosseto, Italy.
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8
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Pertile P, Poli A, Dominioni L, Rotolo N, Nardecchia E, Castiglioni M, Paolucci M, Mantovani W, Imperatori A. Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2015; 13:15. [PMID: 26366122 PMCID: PMC4567810 DOI: 10.1186/s12962-015-0041-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 09/04/2015] [Indexed: 12/18/2022] Open
Abstract
Background After implementation of the PREDICA annual chest X-ray (CXR) screening program in smokers in the general practice setting of Varese-Italy a significant reduction in lung cancer-specific mortality (18 %) was observed. The objective of this study covering July 1997 through December 2006 was to estimate the cost-effectiveness of this intervention. Methods We examined detailed information on lung cancer (LC) cases that occurred among smokers invited to be screened in the PREDICA study (Invitation-to-screening Group, n = 5815 subjects) to estimate costs and quality-adjusted life-years (QALYs) from LC diagnosis until death. The control group consisted of 156 screening-eligible smokers from the same area, uninvited and unscreened, who developed LC and were treated by usual care. We calculated the incremental net monetary benefit (INMB) by comparing LC management in screening participants (n = 1244 subjects) and in the Invitation-to-screening group versus control group. Results The average number of QALYs since LC diagnosis was 1.7, 1.49 and 1.07, respectively, in screening participants, the invitation-to-screening group, and the control group. The average total cost (screening + management) per LC case was higher in screening participants (€17,516) and the Invitation-to-screening Group (€16,167) than in the control group (€15,503). Assuming a maximum willingness to pay of €30,000/QALY, we found that the intervention was cost-effective with high probability: 79 % for screening participation (screening participants vs. control group) and 95 % for invitation-to-screening (invitation-to-screening group vs. control group). Conclusions Based on the PREDICA study, annual CXR screening of high-risk smokers in a general practice setting has high probability of being cost-effective with a maximum willingness to pay of €30,000/QALY.
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Affiliation(s)
- Paolo Pertile
- Department of Economics, University of Verona, Via dell'Artigliere 19, 37129 Verona, Italy
| | - Albino Poli
- Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Lorenzo Dominioni
- Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo, Varese, Italy
| | - Nicola Rotolo
- Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo, Varese, Italy
| | - Elisa Nardecchia
- Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo, Varese, Italy
| | - Massimo Castiglioni
- Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo, Varese, Italy
| | - Massimo Paolucci
- Department of Radiology, Ospedale S. Antonio Abate, Gallarate, Italy
| | - William Mantovani
- Department of Public Health and Community Medicine, University of Verona, Verona, Italy ; Department of Prevention, Public Health Trust, Trento, Italy
| | - Andrea Imperatori
- Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo, Varese, Italy
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9
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Lung cancer screening overdiagnosis: reports of overdiagnosis in screening for lung cancer are grossly exaggerated. Acad Radiol 2015; 22:976-82. [PMID: 25772581 DOI: 10.1016/j.acra.2014.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 10/01/2014] [Accepted: 10/17/2014] [Indexed: 11/20/2022]
Abstract
The National Lung Cancer Screening Trial (NLST) demonstrated a mortality reduction benefit associated with low-dose computed tomography (LDCT) screening for lung cancer. There has been considerable debate regarding the benefits and harms of LDCT lung cancer screening, including the challenges related to its practical implementation. One of the controversies regards overdiagnosis, which conceptually denotes diagnosing a cancer that, either because of its indolent, low-aggressiveness biologic behavior or because of limited life expectancy, is unlikely to result in significant morbidity during the patient's remainder lifetime. In theory, diagnosing and treating these cancers offer no measurable benefit while incurring costs and risks. Therefore, if a screening test detects a substantial number of overdiagnosed cancers, it is less likely to be effective. It has been argued that LDCT screening for lung cancer results in an unacceptably high rate of overdiagnosis. This article aims to defend the opposite stance. Overdiagnosis does exist and to a certain extent is inherent to any cancer-screening test. Nonetheless, the concept is less dualistic and more nuanced than it has been suggested. Furthermore, the average estimates of overdiagnosis in LDCT lung cancer screening based on the totality of published data are likely much lower than the highest published estimates, if a careful definition of a positive screening test reflecting our current understanding of lung cancer biology is utilized. This article presents evidence on why reports of overdiagnosis in lung cancer screening have been exaggerated.
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Kussman RS. The overdiagnosis theory in lung cancer screening: does it make any sense? J Surg Oncol 2013; 109:177-8. [PMID: 24249310 DOI: 10.1002/jso.23491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 10/10/2013] [Indexed: 11/05/2022]
Affiliation(s)
- Russell S Kussman
- Russell S. Kussman, MD, JD, Ste. #473, 1158 26th St.,, Santa Monica, CA 90403. Fax: (310) 573-0165
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