本文由小咖机器人翻译整理

期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02904-z

摘要内容如下：

在全球范围内，肺癌是癌症死亡的主要原因。先前的试验证明，对高危个体进行低剂量计算机断层扫描肺癌筛查，可以将肺癌死亡率降低20%甚至更多。肺癌筛查已得到美国主要指南的批准，超过4，000个站点提供筛查。直到最近，美国以外地区的肺部筛查进展缓慢。在2017年6月至2019年5月期间，安大略省肺癌筛查试点成功招募了7，768名通过使用PLCOM2012NORACE肺癌风险预测模型确定的高危个体。总共有4451名参与者被成功筛选、保留并提供了高质量的随访，包括适当的治疗。在安大略省肺癌筛查试点中，肺癌检出率和早期癌症比例分别为2.4%和79.2%；严重的危害并不常见；检测肺癌的敏感性为95.3%以上。将异常扫描定义为导致诊断调查的异常扫描，特异性为95.5%（阳性预测值为35.1%），对年度回顾和早期监测扫描和临床调查的依从性较高（>85%）。安大略省肺癌筛查试点为如何在全民医疗保健系统内的大型、多样化、人口稠密的地理区域实施基于风险的有组织的肺部筛查计划提供了见解。

英文原文如下：

Abstracts

Globally, lung cancer is the leading cause of cancer death. Previous trials demonstrated that low-dose computed tomography lung cancer screening of high-risk individuals can reduce lung cancer mortality by 20% or more. Lung cancer screening has been approved by major guidelines in the United States, and over 4,000 sites offer screening. Adoption of lung screening outside the United States has, until recently, been slow. Between June 2017 and May 2019, the Ontario Lung Cancer Screening Pilot successfully recruited 7,768 individuals at high risk identified by using the PLCOm2012noRace lung cancer risk prediction model. In total, 4,451 participants were successfully screened, retained and provided with high-quality follow-up, including appropriate treatment. In the Ontario Lung Cancer Screening Pilot, the lung cancer detection rate and the proportion of early-stage cancers were 2.4% and 79.2%, respectively; serious harms were infrequent; and sensitivity to detect lung cancers was 95.3% or more. With abnormal scans defined as ones leading to diagnostic investigation, specificity was 95.5% (positive predictive value, 35.1%), and adherence to annual recall and early surveillance scans and clinical investigations were high (>85%). The Ontario Lung Cancer Screening Pilot provides insights into how a risk-based organized lung screening program can be implemented in a large, diverse, populous geographic area within a universal healthcare system.

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