Detección precoz de cáncer pulmonar con tomografía computarizada de tórax en pacientes con enfermedad pulmonar obstructiva crónica tabáquica

Abstract

Early detection of lung cancer using computed tomography among patients with chronic obstructive pulmonary disease (Rev Med Chile 2016; 144: 202-210)

Cáncer pulmonar: caracterización, estadificación y supervivencia en una cohorte de una década en un hospital del sistema público de salud de Chile

“…En nuestro país, un estudio prospectivo de detección precoz de cáncer pulmonar utilizando tomografía computada de dosis convencional, en pacientes con enfermedad pulmonar obstructiva crónica tabáquica, encontró que más de 90% de los nódulos pulmonares correspondieron a lesiones no neoplásicas durante el seguimiento a 24 meses 38 . Además, una proporción no menor de los casos probables de CPCNP detectados precozmente correspondieron a adultos mayores con contraindicación quirúrgica debido a baja reserva funcional pulmonar 38 . Por estas y otras razones, estudios técnicos del Ministerio de Salud de Chile no recomiendan actualmente la utilización de este método de screening para el cáncer de pulmón en el sistema público 11,39 .…”

Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study

“…6 However, the implementation rates of LDCT screening programmes worldwide are low (4.5% of the eligible population in the USA), 7 8 and only isolated efforts have been reported in Latin America. [8][9][10] To date, there are no local guidelines for recommendations. A consensus of experts was held in Argentina to review the updated literature and obtain recommendations for the implementation of LCS programmes at the local level.…”

“…Panellists were asked to rate each recommendation according to 13 criteria using 13 nine-point Likert scales ranging from 1 (no justification for the recommendation) to 9 (full justification for the recommendation). 13 The 13 criteria used were (1) priority of the specific recommendation, (2) undesirable effects, (3) desired effects, (4) balance between undesirable and desired effects, (5) quality of evidence on effects, (6) degree to which the recommendation conforms to patients' values and preferences, (7) resources needed to implement the recommendation, (8) quality of the evidence on resources needed, (9) cost-effectiveness of the recommendation, (10) degree to which the recommendation promotes equity in access to health, (11) degree of acceptability of the recommendation by professionals, (12) feasibility of implementing the recommendation and (13) degree to which implementation of the recommendation can be measured (table 1). The median obtained for each criterion for each recommendation was weighted by a factor obtained in the rating of the 13 criteria according to the importance given by the experts to each criterion used.…”

Lung Cancer in Chile

“…In most patients, the diagnosis was made in early stages of the disease, and 92% of patients had false-positive results. 10 In countries such as Chile, funding efforts in screening have to be balanced with the eventual different findings of CT and the resolution capacity of our health system. In most of the public hospitals in Chile, lack of radiologists specialized in lung pathology and thoracic surgeons make it unreasonable to pursue a screening program at this moment.…”

“…There are a total of 21 radiotherapy centers counting both private and public institutions. 17 The public sector has seven centers with threedimensional conformal radiation therapy capabilities, and five of them also have intensity-modulated radiation therapy capabilities; this figure is expected to grow significantly according to the new National Cancer Plan 10 that was recently presented by the government. As for stereotactic body radiation therapy, it is still in the very early stages, with only one public center and two private centers using this technique in lung cancer.…”