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Screening for lung cancer: A systematic review and meta-analysis

To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.ypmed.2016.04.015 Byline: Muhammad Usman Ali [aliu@mcmaster.ca] (a,c), John Miller [jmiller@mcmaster.ca] (d), Leslea Peirson [lpeirson@mcmaster.ca] (a,b), Donna Fitzp... Full description

Journal Title: Preventive Medicine August 2016, Vol.89, pp.301-314
Main Author: Usman Ali, Muhammad
Other Authors: Miller, John , Peirson, Leslea , Fitzpatrick-Lewis, Donna , Kenny, Meghan , Sherifali, Diana , Raina, Parminder
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0091-7435 ; E-ISSN: 1096-0260 ; DOI: 10.1016/j.ypmed.2016.04.015
Link: https://www.sciencedirect.com/science/article/pii/S0091743516300706
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recordid: elsevier_sdoi_10_1016_j_ypmed_2016_04_015
title: Screening for lung cancer: A systematic review and meta-analysis
format: Article
creator:
  • Usman Ali, Muhammad
  • Miller, John
  • Peirson, Leslea
  • Fitzpatrick-Lewis, Donna
  • Kenny, Meghan
  • Sherifali, Diana
  • Raina, Parminder
subjects:
  • Lung Cancer
  • Screening
  • Systematic Review
  • Primary Health Care
  • Medicine
  • Public Health
ispartof: Preventive Medicine, August 2016, Vol.89, pp.301-314
description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.ypmed.2016.04.015 Byline: Muhammad Usman Ali [aliu@mcmaster.ca] (a,c), John Miller [jmiller@mcmaster.ca] (d), Leslea Peirson [lpeirson@mcmaster.ca] (a,b), Donna Fitzpatrick-Lewis [fitzd@mcmaster.ca] (a,b), Meghan Kenny [mkenny@mcmaster.ca] (a,c), Diana Sherifali [dsherif@mcmaster.ca] (a,b,*), Parminder Raina [praina@mcmaster.ca] (a,c,*) Keywords Lung cancer; Screening; Systematic review; Primary health care Highlights * The evidence does not support CXR screening with or without sputum cytology. * LDCT screening significantly reduced lung cancer mortality and overall mortality. * Harms include false positives, major complications & death from invasive testing. * Current evidence warrants the need to develop and improve standardized practices. Abstract Objectives To examine evidence on benefits and harms of screening average to high-risk adults for lung cancer using chest radiology (CXR), sputum cytology (SC) and low-dose computed tomography (LDCT). Methods This systematic review was conducted to provide up to date evidence for Canadian Task Force on Preventive Health Care (CTFPHC) lung cancer screening guidelines. Four databases were searched to March 31, 2015 along with utilizing a previous Cochrane review search. Randomized trials reporting benefits were included; any design was included for harms. Meta-analyses were performed if possible. PROSPERO #CRD42014009984. Results Thirty-four studies were included. For lung cancer mortality there was no benefit of CXR screening, with or without SC. Pooled results from three small trials comparing LDCT to usual care found no significant benefits for lung cancer mortality. One large high quality trial showed statistically significant reductions of 20% in lung cancer mortality over a follow-up of 6.5 years, for LDCT compared with CXR. LDCT screening was associated with: overdiagnosis of 10.99--25.83%; 11.18 deaths and 52.03 patients with major complications per 1000 undergoing invasive follow-up procedures; median estimate for false positives of 25.53% for baseline/once-only screening and 23.28% for multiple rounds; and 9.74 and 5.28 individuals per 1000 screened, with benign conditions underwent minor and major invasive follow-up procedures. Conclusion The evidence does not support CXR screening with or without sputum cytology for lung cancer. High quality evidence showed that in se
language: eng
source:
identifier: ISSN: 0091-7435 ; E-ISSN: 1096-0260 ; DOI: 10.1016/j.ypmed.2016.04.015
fulltext: fulltext
issn:
  • 0091-7435
  • 00917435
  • 1096-0260
  • 10960260
url: Link


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titleScreening for lung cancer: A systematic review and meta-analysis
creatorUsman Ali, Muhammad ; Miller, John ; Peirson, Leslea ; Fitzpatrick-Lewis, Donna ; Kenny, Meghan ; Sherifali, Diana ; Raina, Parminder
ispartofPreventive Medicine, August 2016, Vol.89, pp.301-314
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subjectLung Cancer ; Screening ; Systematic Review ; Primary Health Care ; Medicine ; Public Health
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descriptionTo access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.ypmed.2016.04.015 Byline: Muhammad Usman Ali [aliu@mcmaster.ca] (a,c), John Miller [jmiller@mcmaster.ca] (d), Leslea Peirson [lpeirson@mcmaster.ca] (a,b), Donna Fitzpatrick-Lewis [fitzd@mcmaster.ca] (a,b), Meghan Kenny [mkenny@mcmaster.ca] (a,c), Diana Sherifali [dsherif@mcmaster.ca] (a,b,*), Parminder Raina [praina@mcmaster.ca] (a,c,*) Keywords Lung cancer; Screening; Systematic review; Primary health care Highlights * The evidence does not support CXR screening with or without sputum cytology. * LDCT screening significantly reduced lung cancer mortality and overall mortality. * Harms include false positives, major complications & death from invasive testing. * Current evidence warrants the need to develop and improve standardized practices. Abstract Objectives To examine evidence on benefits and harms of screening average to high-risk adults for lung cancer using chest radiology (CXR), sputum cytology (SC) and low-dose computed tomography (LDCT). Methods This systematic review was conducted to provide up to date evidence for Canadian Task Force on Preventive Health Care (CTFPHC) lung cancer screening guidelines. Four databases were searched to March 31, 2015 along with utilizing a previous Cochrane review search. Randomized trials reporting benefits were included; any design was included for harms. Meta-analyses were performed if possible. PROSPERO #CRD42014009984. Results Thirty-four studies were included. For lung cancer mortality there was no benefit of CXR screening, with or without SC. Pooled results from three small trials comparing LDCT to usual care found no significant benefits for lung cancer mortality. One large high quality trial showed statistically significant reductions of 20% in lung cancer mortality over a follow-up of 6.5 years, for LDCT compared with CXR. LDCT screening was associated with: overdiagnosis of 10.99--25.83%; 11.18 deaths and 52.03 patients with major complications per 1000 undergoing invasive follow-up procedures; median estimate for false positives of 25.53% for baseline/once-only screening and 23.28% for multiple rounds; and 9.74 and 5.28 individuals per 1000 screened, with benign conditions underwent minor and major invasive follow-up procedures. Conclusion The evidence does not support CXR screening with or without sputum cytology for lung cancer. High quality evidence showed that in selected high-risk individuals, LDCT screening significantly reduced lung cancer mortality and all-cause mortality. However, for its implementation at a population level, the current evidence warrants the development of standardized practices for screening with LDCT and follow-up invasive testing to maximize accuracy and reduce potential associated harms. Abbreviations CTFPHC, Canadian Task Force on Preventive Health Care; CXR, chest radiography; DANTE, Detection and Screening of Early Lung Cancer by Novel Imaging Technology and Molecular Essays Trial; DLCST, Danish Lung Cancer Screening Trial; GRADE, Grading of Recommendations Assessment, Development and Evaluation; JHS, Johns Hopkins Study; LDCT, low-dose computed tomography; LSS, Lung Screening Study; KFS, Kaiser Foundation Study; MILD, Multi-centric Italian Lung Detection Trial; MLP, Mayo Lung Project; MSK, Memorial Sloan--Kettering Study; NELSON, Nederlands--Leuvens Longkanker Screenings Onderzoek Study; NLS, North London Study; NLST, National Lung Screening Trial; PLCO, Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial; SC, sputum cytology; USPSTF, United States Preventive Services Task Force Author Affiliation: (a) McMaster Evidence Review and Synthesis Centre, McMaster University, 1280 Main St. W., McMaster Innovation Park, Room 207A, Hamilton, Ontario L8S 4K1, Canada (b) School of Nursing, Faculty of Health Sciences, McMaster University, Health Sciences Centre Room HSC-3N25F, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada (c) Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Room HSC-2C, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada (d) Department of Surgery, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada * Corresponding authors at: McMaster Evidence Review and Synthesis Centre, McMaster University, 1280 Main St. W., McMaster Innovation Park, Room 207A, Hamilton, Ontario L8S 4K1, Canada. Article History: Received 10 August 2015; Revised 12 April 2016; Accepted 16 April 2016
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titleScreening for lung cancer: A systematic review and meta-analysis
description

To examine evidence on benefits and harms of screening average to high-risk adults for lung cancer using chest radiology (CXR), sputum cytology (SC) and low-dose computed tomography (LDCT).

This systematic review was conducted to provide up to date evidence for Canadian Task Force on Preventive Health Care (CTFPHC) lung cancer screening guidelines. Four databases were searched to March 31, 2015 along with utilizing a previous Cochrane review search. Randomized trials reporting benefits were included; any design was included for harms. Meta-analyses were performed if possible. PROSPERO #CRD42014009984.

Thirty-four studies were included. For lung cancer mortality there was no benefit of CXR screening, with or without SC. Pooled results from three small trials comparing LDCT to usual care found no significant benefits for lung cancer mortality. One large high quality trial showed statistically significant reductions of 20% in lung cancer mortality...

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abstract

To examine evidence on benefits and harms of screening average to high-risk adults for lung cancer using chest radiology (CXR), sputum cytology (SC) and low-dose computed tomography (LDCT).

This systematic review was conducted to provide up to date evidence for Canadian Task Force on Preventive Health Care (CTFPHC) lung cancer screening guidelines. Four databases were searched to March 31, 2015 along with utilizing a previous Cochrane review search. Randomized trials reporting benefits were included; any design was included for harms. Meta-analyses were performed if possible. PROSPERO #CRD42014009984.

Thirty-four studies were included. For lung cancer mortality there was no benefit of CXR screening, with or without SC. Pooled results from three small trials comparing LDCT to usual care found no significant benefits for lung cancer mortality. One large high quality trial showed statistically significant reductions of 20% in lung cancer mortality...

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