The Korean guideline for lung cancer screening.
10.5124/jkma.2015.58.4.291
- Author:
Seung Hun JANG
1
;
Seungsoo SHEEN
;
Hyae Young KIM
;
Hyeon Woo YIM
;
Bo Young PARK
;
Jae Woo KIM
;
In Kyu PARK
;
Young Whan KIM
;
Kye Young LEE
;
Kyung Soo LEE
;
Jong Mog LEE
;
Bin HWANGBO
;
Sang Hyun PAIK
;
Jin Hwan KIM
;
Nak Jin SUNG
;
Sang Hyun LEE
;
Seung Sik HWANG
;
Soo Young KIM
;
Yeol KIM
;
Won Chul LEE
;
Sook Whan SUNG
Author Information
1. Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University College of Medicine, Chuncheon, Korea.
- Publication Type:Clinical Trial ; Original Article
- Keywords:
Early detection of cancer;
Lung neoplasms;
Clinical practice guidelines;
Low dose chest computed tomography
- MeSH:
Biomarkers, Tumor;
Diagnosis;
Early Detection of Cancer;
Education;
Follow-Up Studies;
Humans;
Korea;
Lung;
Lung Neoplasms*;
Mass Screening*;
Mortality;
Radiography, Thoracic;
Smoke;
Smoking;
Sputum
- From:Journal of the Korean Medical Association
2015;58(4):291-301
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Lung cancer is the leading cause of cancer death in many countries, including Korea. The majority of patients are inoperable at the time of diagnosis because symptoms are typically manifested at an advanced stage. A recent large clinical trial demonstrated significant reduction in lung cancer mortality by using low dose computed tomography (LDCT) screening. A Korean multisociety collaborative committee systematically reviewed the evidences regarding the benefits and harms of lung cancer screening, and developed an evidence-based clinical guideline. There is high-level evidence that annual screening with LDCT can reduce lung cancer mortality and all-cause mortality of high-risk individuals. The benefits of LDCT screening are modestly higher than the harms. Annual LDCT screening should be recommended to current smokers and ex-smokers (if less than 15 years have elapsed after smoking cessation) who are aged 55 to 74 years with 30 pack-years or more of smoking-history. LDCT can discover non-calcified lung nodules in 20 to 53% of the screened population, depending on the nodule positivity criteria. Individuals may undergo regular LDCT follow-up or invasive diagnostic procedures that lead to complications. Radiation-associated malignancies associated with repetitive LDCT, as well as overdiagnosis, should be considered the harms of screening. LDCT should be performed in qualified hospitals and interpreted by expert radiologists. Education and actions to stop smoking must be offered to current smokers. Chest radiograph, sputum cytology at regular intervals, and serum tumor markers should not be used as screening methods. These guidelines may be amended based on several large ongoing clinical trial results.
