Systematic review and meta-analysis on the impact of lung cancer screening by low-dose computed tomography. (July 2020)

• Record Type: Journal Article
• Authors: Sadate, Alexandre; Occean, Bob V.; Beregi, Jean-Paul; Hamard, Aymeric; Addala, Takieddine; de Forges, Hélène; Fabbro-Peray, Pascale; Frandon, Julien
• Is Part Of: European journal of cancer. Volume 134(2020)
• Page Start: 107
• Page End: 114
• Publication Date: 2020-07
• Subjects: Lung cancer -- Screening -- Low-dose computed tomography -- Meta-analysis; CI Confidence Interval -- CXR Chest X-ray -- LC Lung Cancer -- HAS National Authority for Health -- LDCT Low-Dose Computed Tomography -- NLST National Lung Screening Trial -- OR Odds Ratio -- PLCO Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial -- p-yrs person years -- RCT Randomized Controlled Trial -- RR Risk Ratio -- Yrs years; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2020.04.035
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Introduction: Lung cancer (LC) has the highest cancer mortality worldwide with poor prognosis. Screening with low-dose computed tomography (LDCT) in populations highly exposed to tobacco has been proposed to improve LC prognosis. Our objective was to perform a systematic review and meta-analysis to evaluate the efficacy of screening by LDCT compared with any other intervention in populations who reported tobacco consumption for more than 15 years on LC and overall mortality. Methods: We searched randomised controlled trials (RCTs) studying screening by LDCT compared with any other intervention in a population who reported an average smoking history greater than 15 pack-years from inception until the 19th February 2018 using Medline and Cochrane Library databases. Publication selection and data extraction were made independently by two double-blind reviewers. Results: Seven RCTs were included in the meta-analysis which corresponds to 84, 558 participants. A significant relative reduction of LC-specific mortality of 17% (risk ratio [RR] = 0.83, 95% confidence interval [CI]: 0.76–0.91) and a relative reduction of overall mortality of 4% (RR = 0.96, 95% CI: 0.92–1.00) was observed in the screening group compared with the control group. Conclusion: In populations highly exposed to tobacco, screening by LDCT reduces lung cancer mortality. Highlights: Screening with low-dose CT (LDCT) has been proposed to improve lung cancer prognosis. We searched randomised controlled trials studying screening by LDCT. Reduction of LC-specific mortality was observed with LDCT screening.