An umbrella review of systematic evidence on the Low Dose Computed Tomography (LDCT) for lung cancer screening.

IF 2.6 4区医学 Q2 ONCOLOGY

Future oncology Pub Date : 2025-08-01 Epub Date: 2025-07-15 DOI:10.1080/14796694.2025.2531428

Stany Mathew, Gowthaman Thangavel, Praveen Pujar, Apourv Pant, Anita Nath

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引用次数: 0

Abstract

Aim: Despite lung cancer's high mortality rate, many countries still lack organized lung cancer screening programs. This review aims to evaluate the impact of low-dose computed tomography (LDCT) screening on lung cancer diagnosis, mortality, and overall clinical outcomes.

Materials and methods: Following the Joanna Briggs Institute methodology for umbrella reviews, a comprehensive search was conducted in PubMed, Embase, and the Cochrane Library for reviews published between January 2013 and December 2023. Eligible meta-analyses included studies comparing LDCT screening with chest X-ray (CXR) or no screening, reporting outcomes such as sensitivity, specificity, and lung cancer mortality. The methodological quality of the included reviews was assessed using AMSTAR-2.

Results: Out of 801 citations, 14 meta-analyses met the inclusion criteria. LDCT demonstrated high sensitivity (0.97, 95% CI: 0.94-0.98) and specificity (0.87, 95% CI: 0.82-0.91). It significantly increased early-stage lung cancer detection (RR: 1.31, 95% CI: 1.18-1.45) and reduced lung cancer mortality by 18% (RR: 0.82, 95% CI: 0.75-0.90). However, the reduction in all-cause mortality (RR: 0.91, 95% CI: 0.75-1.06) was not statistically significant. Overdiagnosis and false positives remain essential challenges.

Conclusion: This umbrella review confirms that LDCT screening effectively reduces lung cancer mortality, particularly in high-risk populations.

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低剂量计算机断层扫描（LDCT）用于肺癌筛查的系统证据综述。

目的：尽管肺癌的死亡率很高，但许多国家仍然缺乏有组织的肺癌筛查项目。本综述旨在评估低剂量计算机断层扫描（LDCT）筛查对肺癌诊断、死亡率和总体临床结果的影响。材料和方法：按照Joanna Briggs研究所的总结性综述方法，在PubMed、Embase和Cochrane Library中进行了全面的检索，检索了2013年1月至2023年12月间发表的综述。合格的荟萃分析包括比较LDCT筛查与胸部x线检查（CXR）或不筛查的研究，报告敏感性、特异性和肺癌死亡率等结果。采用AMSTAR-2评价纳入的评价的方法学质量。结果：801篇引用中，14篇meta分析符合纳入标准。LDCT显示高灵敏度（0.97,95% CI: 0.94-0.98）和特异性（0.87,95% CI: 0.82-0.91）。它显著提高了早期肺癌的检出率（RR: 1.31, 95% CI: 1.18-1.45），降低了18%的肺癌死亡率（RR: 0.82, 95% CI: 0.75-0.90）。然而，全因死亡率的降低（RR: 0.91, 95% CI: 0.75-1.06）无统计学意义。过度诊断和假阳性仍然是主要的挑战。结论：本综述证实LDCT筛查有效降低肺癌死亡率，特别是在高危人群中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Future oncology ONCOLOGY-

CiteScore

5.40

自引率

3.00%

发文量

335

审稿时长

4-8 weeks

期刊介绍： Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community. The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.