Cancer-Specific Mortality, All-Cause Mortality, and Overdiagnosis in Lung Cancer Screening Trials: A Meta-Analysis

Ebell, Mark H.; Bentivegna, Michelle; Hulme, Cassie

doi:10.1370/afm.2582

Cited by 28 publications

(21 citation statements)

References 28 publications

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“…Based on a systematic literature review, we performed a meta-analysis of eight RCTs on LDCT lung cancer screening, including the latest results from European trials published in 2020, comprising a total of more than 87,000 participants. The estimated relative reduction of lung cancer mortality by screening with LDCT was 20% when compared to no screening and 12% across all considered studies, which confirms earlier studies [70][71][72][73]. Although the meta-analysis of included studies did not provide proof of a benefit in all-cause mortality, the effect estimates of most individual studies tend in the same direction as for the lungcancer-specific mortality and indicate a protective effect.…”

Section: Discussionsupporting

confidence: 79%

Lung Cancer Screening with Low-Dose CT in Smokers: A Systematic Review and Meta-Analysis

et al. 2021

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Lung cancer continues to be one of the main causes of cancer death in Europe. Low-dose computed tomography (LDCT) has shown high potential for screening of lung cancer in smokers, most recently in two European trials. The aim of this review was to assess lung cancer screening of smokers by LDCT with respect to clinical effectiveness, radiological procedures, quality of life, and changes in smoking behavior. We searched electronic databases in April 2020 for publications of randomized controlled trials (RCT) reporting on lung cancer and overall mortality, lung cancer morbidity, and harms of LDCT screening. A meta-analysis was performed to estimate effects on mortality. Forty-three publications on 10 RCTs were included. The meta-analysis of eight studies showed a statistically significant relative reduction of lung cancer mortality of 12% in the screening group (risk ratio = 0.88; 95% CI: 0.79–0.97). Between 4% and 24% of screening-LDCT scans were classified as positive, and 84–96% of them turned out to be false positive. The risk of overdiagnosis was estimated between 19% and 69% of diagnosed lung cancers. Lung cancer screening can reduce disease-specific mortality in (former) smokers when stringent requirements and quality standards for performance are met.

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Section: Discussionsupporting

confidence: 79%

Lung Cancer Screening with Low-Dose CT in Smokers: A Systematic Review and Meta-Analysis

et al. 2021

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“…A significant relative reduction of lung cancer-specific mortality of 17% (RR =0.83, 95% 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. Another meta-analysis, this time based on eight trials with 90,475 patients had a low risk of bias (20). There was a significant reduction in lung cancer-specific mortality with LD-SCT screening (relative risk =0.81; 95% CI: 0.74-0.89); the estimated absolute risk reduction was 0.4% (number needed to screen =250).…”

Section: Lung Cancer Screening In Europe: Efforts and Endeavoursmentioning

confidence: 99%

Lung cancer screening in Europe: where are we in 2021?

Meerbeeck¹,

Franck²

2021

Transl Lung Cancer Res

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In the Global Burden of Disease Studies, lung cancer is a leading cause of years of life lost (YLL) and of disabilityadjusted life-years (DALYs): according to the Causes of Death Collaborators, it moved from the 17 th most prevalent cause of death in 1990 to the 14 th in 2007 and the 12 th in 2017, representing a worldwide number of lung cancer deaths in 2017 of 1,883,100 and a more than 29% increase compared to 2007 (1,2). It furthermore ranks 17 th among the causes of DALY, representing 1.8% of DALYs in all ages and 3.9% of DALYs among adults aged 50-74 years (3).With more than 2,000,000 incidental cases and 1,760,000 deaths, lung cancer represents 11.6% of the 18.1 million new cases of cancer worldwide and 18.4% of its mortality (4). With a death rate of more than 85%, lung cancer in Europe represents 3% of all causes of death and around 20% of cancer deaths, one third of them occurring in women. With one death every 83 seconds, the estimated number of European citizens dying from lung cancer in 2018 was Review Article on Lung Cancer Screening

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“…Firstly, tobacco use, a well-known cause of lung cancer, is crucial for promoting oncogenesis, affecting both disease progression and response to therapy [ 15 ]. With a prevalence at time of diagnosis reaching 60%, smoking does represent the number one preventable risk factor for lung cancer genesis [ 1 , 2 ]. Loss of tumor suppressor genes, such as p53, and mutation of oncogenes, such as Kras, may occur as result of chronic exposure to tobacco compounds [ 3 ].…”

Section: General Information About Lung Cancer: Incidence Risk Famentioning

confidence: 99%

“…Lung cancer (LC) remains the leading cause of cancer death worldwide accounting for 14.1 million new cancer cases and 8.2 million deaths per year [ 1 , 2 ]. There are several factors to prevent and manage complications and/or poor prognosis of lung cancer such as nutritional approach and physical activity [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Food, Nutrition, Physical Activity and Microbiota: Which Impact on Lung Cancer?

Nigro

Perrotta

Scialò

et al. 2021

IJERPH

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Lung cancer still represents the leading cause of cancer-related death, globally. Likewise, malnutrition and inactivity represent a major risk for loss of functional pulmonary capacities influencing overall lung cancer severity. Therefore, the adhesion to an appropriate health lifestyle is crucial in the management of lung cancer patients despite the subtype of cancer. This review aims to summarize the available knowledge about dietary approaches as well as physical activity as the major factors that decrease the risk towards lung cancer, and improve the response to therapies. We discuss the most significant dietary schemes positively associated to body composition and prognosis of lung cancer and the main molecular processes regulated by specific diet schemes, functional foods and physical activity, i.e., inflammation and oxidative stress. Finally, we report evidence demonstrating that dysbiosis of lung and/or gut microbiome, as well as their interconnection (the gut–lung axis), are strictly related to dietary patterns and regular physical activity playing a key role in lung cancer formation and progression, opening to the avenue of modulating the microbiome as coadjuvant therapy. Altogether, the evidence reported in this review highlights the necessity to consider non-pharmacological interventions (nutrition and physical activity) as effective adjunctive strategies in the management of lung cancer.

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Cancer-Specific Mortality, All-Cause Mortality, and Overdiagnosis in Lung Cancer Screening Trials: A Meta-Analysis

Cited by 28 publications

References 28 publications

Lung Cancer Screening with Low-Dose CT in Smokers: A Systematic Review and Meta-Analysis

Lung Cancer Screening with Low-Dose CT in Smokers: A Systematic Review and Meta-Analysis

Lung cancer screening in Europe: where are we in 2021?

Food, Nutrition, Physical Activity and Microbiota: Which Impact on Lung Cancer?

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