Low-dose CT screening can reduce cancer mortality: A meta-analysis

SUMMARY OBJECTIVE Lung cancer is the leading cause of cancer-related death. To reduce lung cancer mortality and detect lung cancer in early stages, low dose CT screening is required. A meta-analysis was conducted to verify whether screening could reduce lung cancer mortality and to determine the optimal screening program. METHODS We searched PubMed, Web of Science, Cochrane library, ScienceDirect, and relevant Chinese databases. Randomized controlled trial studies with participants that were smokers older than 49 years (smoking >15 years or quit smoking 10 or 15 years ago) were included. RESULTS Nine RCT studies met the criteria. LDCT screening could find more lung cancer cases (RR=1.58, 95%CI=1.25-1.99, P<0.001) and more stage I lung cancers (RR=3.45, 95%CI=2.08-5.72, P<0.001) compared to chest-X ray or the no screening group. This indicated a statistically significant reduction in lung-cancer-specific mortality (RR=0.84, 95%CI=0.75-0.95, P=0.004), but without a statistically reduction in mortality due to all causes (RR=1.26, 95%CI=0.89-1.78, P=0.193). Annually, LDCT screening was sensitive in finding more lung cancers. CONCLUSIONS Low-dose CT screening is effective in finding more lung cancer cases and decreasing the deaths from lung cancer. Annual low-dose CT screening may be better than a biennial screening to detect more early-stage lung cancer cases.

RESUMO OBJETIVO O câncer de pulmão é a principal causa de mortes relacionadas ao câncer. Para reduzir a mortalidade por câncer de pulmão e encontrar câncer de pulmão em um estágio inicial, é necessária uma triagem por tomografia de baixa dose. Uma meta-análise foi emitida para testemunhar se a triagem poderia reduzir a mortalidade por câncer de pulmão e investigar o melhor programa de triagem. MÉTODOS Pesquisamos PubMed, Web of Science, biblioteca Cochrane, ScienceDirect e relevante banco de dados chinês. Ensaios clínicos controlados aleatórios, em que os participantes eram fumantes com mais de 49 anos (tabagismo >15 anos ou parar de fumar 10 ou 15 anos atrás) foram incluídos. RESULTADOS Nove estudos RCT preencheram os critérios. O rastreamento de LDCT pôde encontrar mais cânceres de pulmão (RR=1,58, IC 95%=1,25-1,99, P<0,001) e mais cânceres de estágio I do pulmão (RR=3,45, IC 95%=2,08-5,72, P<0,001) em comparação com raio X do tórax ou nenhum grupo de triagem. Ele indicou uma redução estatisticamente significativa na mortalidade específica do câncer de pulmão (RR=0,84, IC 95%=0,75-0,95, P=0,004), mas sem uma redução estatisticamente significativa na mortalidade por todas as causas (RR=1,26, IC 95%=0,89-1,78, P=0,193). Anualmente, o rastreamento de LDCT foi sensível em encontrar mais cânceres de pulmão. CONCLUSÕES A triagem de TC de baixa dose é eficaz para encontrar mais cânceres de pulmão e diminuir as mortes por câncer de pulmão. Para encontrar mais cânceres de pulmão em estágio inicial, a triagem anual de tomografia de baixa dose pode ser melhor do que a triagem bianual.

Low-dose CT screening can reduce cancer mortality: A meta-analysis.

OBJECTIVE: Lung cancer is the leading cause of cancer-related death. To reduce lung cancer mortality and detect lung cancer in early stages, low dose CT screening is required. A meta-analysis was conducted to verify whether screening could reduce lung cancer mortality and to determine the optimal screening program. METHODS: We searched PubMed, Web of Science, Cochrane library, ScienceDirect, and relevant Chinese databases. Randomized controlled trial studies with participants that were smokers older than 49 years (smoking >15 years or quit smoking 10 or 15 years ago) were included. RESULTS: Nine RCT studies met the criteria. LDCT screening could find more lung cancer cases (RR=1.58, 95%CI=1.25-1.99, P<0.001) and more stage I lung cancers (RR=3.45, 95%CI=2.08-5.72, P<0.001) compared to chest-X ray or the no screening group. This indicated a statistically significant reduction in lung-cancer-specific mortality (RR=0.84, 95%CI=0.75-0.95, P=0.004), but without a statistically reduction in mortality due to all causes (RR=1.26, 95%CI=0.89-1.78, P=0.193). Annually, LDCT screening was sensitive in finding more lung cancers. CONCLUSIONS: Low-dose CT screening is effective in finding more lung cancer cases and decreasing the deaths from lung cancer. Annual low-dose CT screening may be better than a biennial screening to detect more early-stage lung cancer cases.