Sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms: a systematic review.
Br J Gen Pract
; 69(689): e827-e835, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31636130
ABSTRACT
BACKGROUND:
Despite increasing use of computed tomography (CT), chest X-ray remains the first-line investigation for suspected lung cancer in primary care in the UK. No systematic review evidence exists as to the sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms.AIM:
To estimate the sensitivity of chest X-ray for detecting lung cancer in symptomatic people. DESIGN ANDSETTING:
A systematic review was conducted to determine the sensitivity of chest X-ray for the detection of lung cancer.METHOD:
Databases including MEDLINE, EMBASE, and the Cochrane Library were searched; a grey literature search was also performed.RESULTS:
A total of 21 studies met the eligibility criteria. Almost all were of poor quality. Only one study had the diagnostic accuracy of chest X-ray as its primary objective. Most articles were case studies with a high risk of bias. Several were drawn from non-representative groups, for example, specific presentations, histological subtypes, or comorbidities. Only three studies had a low risk of bias. Two primary care studies reported sensitivities of 76.8% (95% confidence interval [CI] = 64.5 to 84.2%) and 79.3% (95% CI = 67.6 to 91.0%). One secondary care study reported a sensitivity of 79.7% (95% CI = 72.7 to 86.8%).CONCLUSION:
Though there is a paucity of evidence, the highest-quality studies suggest that the sensitivity of chest X-ray for symptomatic lung cancer is only 77% to 80%. GPs should consider if further investigation is necessary in high-risk patients who have had a negative chest X-ray.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Radiografia Torácica
/
Neoplasias Pulmonares
Tipo de estudo:
Diagnostic_studies
/
Screening_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Br J Gen Pract
Ano de publicação:
2019
Tipo de documento:
Article