https://doi.org/10.4081/monaldi.2022.2284
Role of low dose computed tomography on lung cancer detection and mortality - an updated systematic review and meta-analysis
Submitted: April 2, 2022
Accepted: May 30, 2022
Published: June 21, 2022
Accepted: May 30, 2022
Abstract Views: 1341
PDF: 449
Supplementary: 92
Supplementary: 92
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Chest low dose computed tomography (LDCT) is reported to be a sensitive tool for the detection of lung cancer at asymptomatic stage, thus reducing mortality. The review assesses the effect of LDCT screening on all-cause mortality, lung cancer mortality and incidence rates. We conducted literature searches of PubMed, SCOPUS, and the Cochrane Library from inception through January 2020 to identify relevant studies assessing the diagnostic accuracy of LDCT for lung cancer. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for reporting this meta-analysis and review. The inclusion criteria were a) Randomized control trials, b) Comparing LDCT to any other form of screening or standard of care, and (c) Primary outcome studied: all-cause mortality, lung cancer-specific mortality, rate of early detection of lung cancer. A total of 11 studies encompassing 97,248 patients were included. When compared with controls (no screening or CXR), LDCT screening was associated with statistically significant reduction in lung cancer mortality (pooled RR 0.86; 95% CI 0.75-0.98); low heterogeneity was observed (I2= 27.86). However, LDCT screening was not associated with statistically significant reduction in all-cause mortality (RR =0.96; 95% CI: 0.92 -1.01). Notably, the LDCT screening was associated with statistically significant increase in lung cancer detection (RR =1.76; 95% CI: 1.14-2.72). LDCT screening has the potential to reduce mortality due to lung cancer among high-risk individuals. LDCT could be considered as a screening modality after careful assessment of other factors like prevalence of TB, proportion of high-risk population, cost, access and availability of LDCT.
National Cancer Institute [Internet]. Cancer Stat Facts: Lung and Bronchus Cancer. Accessed: 2019 Mar 28. Available from: https://seer.cancer.gov/statfacts/html/lungb.html
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424.
DOI: https://doi.org/10.3322/caac.21492
Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 2016;66:271-89.
DOI: https://doi.org/10.3322/caac.21349
De Koning HJ, Van Der Aalst CM, De Jong PA, et al. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med 2020;382:503-13.
DOI: https://doi.org/10.1056/NEJMoa1911793
The National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011;365:395-409.
DOI: https://doi.org/10.1056/NEJMoa1102873
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PloS Med 2009;6:e1000097.
DOI: https://doi.org/10.1371/journal.pmed.1000097
Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928.
DOI: https://doi.org/10.1136/bmj.d5928
Gohagan J, Marcus P, Fagerstrom R, et al. Baseline findings of a randomized feasibility trial of lung cancer screening with spiral CT scan vs chest radiograph: The Lung Screening Study of the National Cancer Institute. Chest 2004;126:114-21.
DOI: https://doi.org/10.1378/chest.126.1.114
Becker N, Motsch E, Gross ML, et al. Randomized study on early detection of lung cancer with MSCT in Germany: Results of the first 3 years of follow-up after randomization. J Thorac Oncol 2015;10:890-6.
DOI: https://doi.org/10.1097/JTO.0000000000000530
Blanchon T, Bréchot JM, Grenier PA, et al. Baseline results of the Depiscan study: A French randomized pilot trial of lung cancer screening comparing low dose CT scan (LDCT) and chest X-ray (CXR). Lung Cancer 2007;58:50-8.
DOI: https://doi.org/10.1016/j.lungcan.2007.05.009
Paci E, Puliti D, Lopes Pegna A, et al. Mortality, survival and incidence rates in the ITALUNG randomised lung cancer screening trial. Thorax 2017;72:825-31.
DOI: https://doi.org/10.1136/thoraxjnl-2016-209825
Wille MMW, Dirksen A, Ashraf H, et al. Results of the randomized Danish lung cancer screening trial with focus on high-risk profiling. Am J Respir Crit Care Med 2016;193:542-51.
DOI: https://doi.org/10.1164/rccm.201505-1040OC
Pastorino U, Rossi M, Rosato V, et al. Annual or biennial CT screening versus observation in heavy smokers: 5-year results of the MILD trial. Eur J Cancer Prev 2012;21:308-15.
DOI: https://doi.org/10.1097/CEJ.0b013e328351e1b6
Infante M, Cavuto S, Lutman FR, et al. A randomized study of lung cancer screening with spiral computed tomography: Three-year results from the DANTE trial. Am J Respir Crit Care Med 2009;180:445-53.
DOI: https://doi.org/10.1164/rccm.200901-0076OC
Field JK, Duffy SW, Baldwin DR, et al. The UK lung cancer screening trial: A pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer. Health Technol Assess (Rockv) 2016;20:1-146.
DOI: https://doi.org/10.3310/hta20400
Yang W, Qian F, Teng J, et al. Community-based lung cancer screening with low-dose CT in China: Results of the baseline screening. Lung Cancer 2018;117:20-6.
DOI: https://doi.org/10.1016/j.lungcan.2018.01.003
Huang KL, Wang SY, Lu WC, et al. Effects of low-dose computed tomography on lung cancer screening: A systematic review, meta-analysis, and trial sequential analysis. BMC Pulm Med 2019;19:1-11.
DOI: https://doi.org/10.1186/s12890-019-0883-x
Wood DE, Kazerooni EA, Baum SL, et al. Lung cancer screening, version 3.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2018;16:412-41.
DOI: https://doi.org/10.6004/jnccn.2018.0020
The International Early Lung Cancer Action Program Investigators, Henschke CI, Yankelevitz DF, et al. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006;355:1763–71.
DOI: https://doi.org/10.1056/NEJMoa060476
Connell B, McKee B, McKee A, et al. Diagnostic workload generated by a low-dose CT lung screening program - The Lahey experience. Am J Respir Crit Care Med 2014;189:A6308.
Kumar V, Cohen JT, Van Klaveren D, et al. Risk-targeted lung cancer screening a cost-effectiveness analysis. Ann Intern Med 2018;168:161-9.
DOI: https://doi.org/10.7326/M17-1401
Shankar A, Saini D, Dubey A, et al. Feasibility of lung cancer screening in developing countries: Challenges, opportunities and way forward. Transl Lung Cancer Res 2019;8:S106-21.
DOI: https://doi.org/10.21037/tlcr.2019.03.03
How to Cite
Agrawal, Sumita, Akhil Dhanesh Goel, Nitesh Gupta, and Ayush Lohiya. 2022. “Role of Low Dose Computed Tomography on Lung Cancer Detection and Mortality - an Updated Systematic Review and Meta-Analysis”. Monaldi Archives for Chest Disease 93 (1). https://doi.org/10.4081/monaldi.2022.2284.
Copyright (c) 2022 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Paolo Ruggeri, Federica Lo Bello, Francesco Nucera, Michele Gaeta, Francesco Monaco, Gaetano Caramori, Giuseppe Girbino, Hereditary hyperhomocysteinemia associated with nephrotic syndrome complicated by artery thrombosis and chronic thromboembolic pulmonary hypertension: A case report , Monaldi Archives for Chest Disease: Vol. 87 No. 3 (2017)
- Elisa Calabrò, Ugo Pastorino, Primary sternal tuberculosis mimicking a lytic bone tumor lesion , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
- M. Shameem, J. Akhtar, U. Baneen, N. Ahmad Khan, R. Bhargava, Z. Ahmed, M. Shahid, M. Azfar Siddiqui, Malignant melanoma presenting as an isolated pleural effusion , Monaldi Archives for Chest Disease: Vol. 75 No. 2 (2011): Pulmonary series
- Varvara Solodovnikova, Ajay M.V. Kumar, Hennadz Hurevich, Yuliia Sereda, Vera Auchynka, Dzmitry Katovich, Dzmitry Klimuk, Aliaksandr Skrahin, Svetlana Setkina, Iryna Charnysh, Askar Yedilbayev, Alena Skrahina, Effectiveness and safety of delamanid- or bedaquiline-containing regimens among children and adolescents with multidrug resistant or extensively drug resistant tuberculosis: A nationwide study from Belarus, 2015-19 , Monaldi Archives for Chest Disease: Vol. 91 No. 1 (2021)
- Deepak Sharma, Vinay V, Jitendra Kumar Saini, Prabhpreet Sethi, Lokender Kumar, Praveen Kumar Dubey, Assessing the effectiveness and safety of transbronchial lung cryobiopsy utilizing a flexible bronchoscope with an endobronchial blocker in diffuse parenchymal lung lesions , Monaldi Archives for Chest Disease: Early Access
- Yoldez Houcine, Chirine Moussa, Ahmed Ben Abdelaziz, Aida Ayadi, PDL1 and molecular biomarkers expression in non-small cell lung cancer in Tunisian patients , Monaldi Archives for Chest Disease: Early Access
- Vinay V, Saraansh Bansal, Pallavi Purwar, Ravindra Kumar Dewan, Paras Verma, Shalini Mullick, Mallika Dixit, B Rama Phanindra , Kanishk Siddhartha, Thoracic follicular dendritic cell sarcoma - an outlandish presentation of a rare tumour with review of literature , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Barbara Bordoni, Stefano Urbinati, Alicia Tosoni, Graziana Labanti, Alba Brandes, Cardiologic evaluation of patients undergoing chemoterapy , Monaldi Archives for Chest Disease: Vol. 82 No. 2 (2014): Cardiac series
- Rajesh Venkataram, Srividya Arjuna, Giridhar Belur Hosmane, Anirban Chakraborty, Quantitative analysis of cell-free DNA by droplet digital PCR reveals the presence of EGFR mutations in non-malignant lung pathologies , Monaldi Archives for Chest Disease: Vol. 91 No. 3 (2021)
- L. Dominioni, N. Rotolo, A. Poli, M. Castiglioni, M. Mangini, M. Spagnoletti, M. Paolucci, A. Paddeu, W. Mantovani, A. Zanini, A. Imperatori, Cost of a population-based programme of chest x-ray screening for lung cancer , Monaldi Archives for Chest Disease: Vol. 79 No. 2 (2013): Pulmonary series
<< < 1 2 3 4 5 6 7 8 9 10 > >>
You may also start an advanced similarity search for this article.
