Accuracy of baseline low-dose computed tomography lung cancer screening: a systematic review and meta-analysis.
10.1097/CM9.0000000000002353
- Author:
Lanwei GUO
1
;
Yue YU
2
;
Funa YANG
3
;
Wendong GAO
4
;
Yu WANG
5
;
Yao XIAO
5
;
Jia DU
6
;
Jinhui TIAN
7
;
Haiyan YANG
8
Author Information
1. Department of Cancer Epidemiology and Prevention, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan 450008, China.
2. Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
3. Department of Nursing, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan 450008, China.
4. Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China.
5. Nursing and Health School of Zhengzhou University, Zhengzhou, Henan 450001, China.
6. International College of Zhengzhou University, Zhengzhou, Henan 450001, China.
7. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China.
8. Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Adult;
Middle Aged;
Aged;
Lung Neoplasms/diagnostic imaging*;
Early Detection of Cancer;
Sensitivity and Specificity;
Mass Screening;
Tomography, X-Ray Computed
- From:
Chinese Medical Journal
2023;136(9):1047-1056
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Screening using low-dose computed tomography (LDCT) is a more effective approach and has the potential to detect lung cancer more accurately. We aimed to conduct a meta-analysis to estimate the accuracy of population-based screening studies primarily assessing baseline LDCT screening for lung cancer.
METHODS:MEDLINE, Excerpta Medica Database, and Web of Science were searched for articles published up to April 10, 2022. According to the inclusion and exclusion criteria, the data of true positives, false-positives, false negatives, and true negatives in the screening test were extracted. Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the literature. A bivariate random effects model was used to estimate pooled sensitivity and specificity. The area under the curve (AUC) was calculated by using hierarchical summary receiver-operating characteristics analysis. Heterogeneity between studies was measured using the Higgins I2 statistic, and publication bias was evaluated using a Deeks' funnel plot and linear regression test.
RESULTS:A total of 49 studies with 157,762 individuals were identified for the final qualitative synthesis; most of them were from Europe and America (38 studies), ten were from Asia, and one was from Oceania. The recruitment period was 1992 to 2018, and most of the subjects were 40 to 75 years old. The analysis showed that the AUC of lung cancer screening by LDCT was 0.98 (95% CI: 0.96-0.99), and the overall sensitivity and specificity were 0.97 (95% CI: 0.94-0.98) and 0.87 (95% CI: 0.82-0.91), respectively. The funnel plot and test results showed that there was no significant publication bias among the included studies.
CONCLUSIONS:Baseline LDCT has high sensitivity and specificity as a screening technique for lung cancer. However, long-term follow-up of the whole study population (including those with a negative baseline screening result) should be performed to enhance the accuracy of LDCT screening.
