The clinical effectiveness and cost-effectiveness of computed tomography screening for lung cancer: systematic reviews

Black, Corrinda; Bagust, A; Boland, Angela; Walker, Simon; McLeod, C; Verteuil, Robyn De; Ayres, J.; Bain, L.; Thomas, Siân; Godden, D. J.; Waugh, Norman

doi:10.3310/hta10030

Cited by 52 publications

(56 citation statements)

References 58 publications

(202 reference statements)

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“…In general, chest CT has a high NPV value (99.4-99.9%) with a moderate positive predictive value (PPV; 2.7-18%) as demonstrated by different study results [148,[154][155][156][157]. Based on the results of the currently available studies, CT-based lung cancer screening is not recommended by experts [158,159].…”

Section: Lung Cancer Screeningmentioning

confidence: 99%

Exhaled biomarkers in lung cancer

Horváth

Lázár

Gyulai

et al. 2009

European Respiratory Journal

237

203

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Lung cancer is the leading cause of cancer death. Results of therapeutic interventions are particularly discouraging when the disease is discovered in an advanced stage. Early diagnosis is limited by the fact that the disease usually develops asymptomatically and available screening methods do not fulfil the requirements for reliable discrimination between patients with lung cancer and subjects not suffering from the disease. Breath sampling is completely noninvasive and provides a potentially useful approach to screening lung cancer. Exhaled biomarkers contain both volatile and nonvolatile molecules. The profile of volatile organic compounds is different in patients with lung cancer than in control subjects. In exhaled breath condensate, the proteomic profile of breath from cancer patients differs from that of healthy smokers. We reviewed the scientific evidence demonstrating that a unique chemical signature can be detected in the breath of patients with lung cancer and that the exhaled breath biomarker profile could aid clinical decision making.KEYWORDS: Biomarker, electronic nose, exhaled breath, exhaled breath condensate, lung cancer, smell L ung cancer is the leading cause of global cancer death in both males and females. According to the most recent projection of global mortality, by 2030 it will emerge as the third and the fifth leading cause of death in highand middle-income countries, respectively [1,2]. Figures on disease outcome measures are very discouraging as even with the most advanced treatment strategies ,86% of lung cancer patients die within 5 yrs of diagnosis. With early detection and treatment, however, the 5-yr survival rate improves dramatically from 20% in patients with stage III lung cancer to 70% in patients with stage I disease [3]. Researchers, therefore, have sought out screening tests to detect lung cancer in the earliest stages and several promising new approaches have been proposed for this purpose, such as computer-assisted image analysis of chest radiographs, spiral computed tomography (CT) scanning, PCR-based assays of sputum and fluorescence bronchoscopy [4][5][6][7].Breath chemical tests have a broad spectrum of applications ranging from the US Food and Drug Administration-approved exhaled nitric oxide fraction (FeNO) measurement to monitor the effect of anti-inflammatory treatment in asthma, to volatile organic compound (VOC) determination and nonvolatile biomarker profiling in the cooled breath sample called exhaled breath condensate (EBC) [8][9][10][11]. Being completely noninvasive, sampling of the breath allows clinicians and researchers to assess different body functions in a flexible manner. Breath collection can be performed even in very severe patients and also repeated within short intervals. Therefore, breath testing is considered to be a potentially ideal candidate for screening purposes. Besides widely known constituents such as nitrogen, oxygen, carbon dioxide, inert gases and water vapour, exhaled breath also consists of thousands of volatile and nonv...

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Section: Lung Cancer Screeningmentioning

confidence: 99%

Exhaled biomarkers in lung cancer

Horváth

Lázár

Gyulai

et al. 2009

European Respiratory Journal

237

203

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“…This may in part explain the high frequency of potentially important clinically unsuspected findings on computed tomography (CT); reported to range from 3% (20) to as high as 49% (21)(22)(23). Compared to CT, MRI has traditionally been performed as a more focused study.…”

Section: Discussionmentioning

confidence: 99%

Rapid multiplanar abdominal survey using MRI with the steady‐state free‐precession technique

Dutka

Bergin

O’Kane

et al. 2007

Magnetic Resonance Imaging

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Purpose: To retrospectively evaluate the sensitivity, specificity, and positive and negative predictive values of steadystate free-precession (SSFP) survey MRI of the abdomen. Materials and Methods:A total of 375 consecutive outpatients underwent abdominal MRI at 1.5T. Excluding diffuse metastatic disease, 110 patients had at least one other clinically important finding. The SSFP survey included contiguous 5-mm-thick axial, sagittal, and coronal slices (total 90 slices) obtained during a total of 90 seconds of free breathing. Studies were reviewed by two experienced MRI readers independently, randomized, blinded, and at different sittings. The chi-squared test was used to compare SSFP to full MRI for showing clinically important findings. In a subset of 30 patients, confidence intervals (CI) were calculated to compare the accuracy of SSFP and full MRI as predictors of biopsy result.Results: SSFP detected 87.3% of clinically important findings and 93.3% of malignancies reported on the full MRI, with a 1.5% false-positive rate. Significant association was shown between SSFP and full MRI for clinically important findings (P Ͻ 0.0001). Compared to biopsy, accuracy of SSFP was high (85% Ϯ 12.7%), though not as high as full MRI (93.3% Ϯ 8.8%).Conclusion: SSFP provides a rapid survey of the abdomen, with good sensitivity and few false positives.

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“…A contrary report was published as part of a health technology assessment, which suggested that lung cancer screening would not be cost-effective [26] . However, it should be considered that this report was issued prior to the results of most of the recent large lung cancer screening trials.…”

Section: Ctmentioning

confidence: 99%

Lung cancer screening: Computed tomography or chest radiographs?

Beek

Mirsadraee

Murchison

2015

WJR

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Worldwide, lung cancer is the leading cause of mortality due to malignancy. The vast majority of cases of lung cancer are smoking related and the most effective way of reducing lung cancer incidence and mortality is by smoking cessation. In the Western world, smoking cessation policies have met with limited success. The other major means of reducing lung cancer deaths is to diagnose cases at an earlier more treatable stage employing screening programmes using chest radiographs or low dose computed tomography. In many countries smoking is still on the increase, and the sheer scale of the problem limits the affordability of such screening programmes. This short review article will evaluate the current evidence and potential areas of research which may benefit policy making across the world.

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The clinical effectiveness and cost-effectiveness of computed tomography screening for lung cancer: systematic reviews

Cited by 52 publications

References 58 publications

Exhaled biomarkers in lung cancer

Exhaled biomarkers in lung cancer

Rapid multiplanar abdominal survey using MRI with the steady‐state free‐precession technique

Lung cancer screening: Computed tomography or chest radiographs?

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