A meta-analysis: is low-dose computed tomography a superior method for risky lung cancers screening population?

ABSTRACT

BACKGROUND AND AIMS: Low-dose computed tomography (LDCT) has been proposed to be a new screening method to discover lung cancers in an early stage, especially those patients who are in a high risk of lung cancer. The primary objective of this meta-analysis is to systematically review the effect of LDCT on screening for lung cancers among the risky population who are older than 49 years old and with smoking exposure. METHODS: We searched randomized controlled clinical trials (RCTs) about comparing LDCT and chest X-ray or usual caring from MEDLINE, EMBASE, and the Cochrane Library, Web of Knowledge and SpringerLink databases (January 1994 to September 2013). RESULTS: Nine RCTs met criteria for inclusion. Screening for lung cancer using LDCT resulted in a significantly higher number of stage I lung cancers [odds ratio (OR) 2.15, 95% confidence interval (CI) 1.88-2.47], higher number of total lung cancers (OR 1.31, 95% CI 1.20-1.43) than the control. Four of the nine studies indicated that the screening method did not decrease all-cause mortality (OR 0.96, 95% CI 0.90-1.02), but decreased lung cancer-specific mortality (OR 0.84, 95% CI 0.74-0.96). Five studies showed that LDCT had higher false-positive rates (OR 8.7, 95% CI 7.43-10.19) than the group of control. CONCLUSION: Among the risky population, LDCT screening find out more stage I lung cancers and total lung cancers compared with chest X-ray or no screening, and also shows advantages in decreasing lung cancer-specific mortality, but the screening method does not decrease all-cause mortality and have a higher false-positive rates in diagnosis.