Abstract 1597P
Background
Lung cancer is the leading cause of cancer death and has a lower relative survival rate than other types of cancer. The survival rates of lung cancer at earlier stages are higher than later stages. A screening test that detects the disease at an early stage would facilitate early treatment, with the consequent mortality reduction and survival improvement. Our main objective is to determine whether screening high-risk patients with Low Dose CT (LDCT) reduces mortality and therefore it can be recommended at a population level.
Methods
We carried out a systematic review of the literature following the PRISMA criteria in the MEDLINE, EMBASE, and Isi Web of Science databases.
Results
Seven randomized clinical trials met the criteria. Due to the great heterogeneity methodology of clinical trials, we have carried out a qualitative synthesis of the studies. The National Lung Screening Trial (NLST) and The NELSON Trial have shown a significant reduction in lung cancer mortality, RR=0.84; 95% CI [0.75–0.95] and RR=0.76; 95% CI [0.61–0.94] respectively. In addition, a significant decrease in lung cancer mortality was found in the subgroup of women in the The LUSI Trial (RR = 0.31 [95% CI: 0.10–0.96]), The NELSON (RR = 0.67 [95% CI: 0.38 -1.14]), and The NLST (RR = 0.73 [95% CI: 0.60–0.9]). The NLST is the only study to show a reduction in mortality due to all causes (RR=0,93 [95% CI:0,86–0,99]). Even though a reduction in long-term lung cancer mortality has been demonstrated, screening implantation implies questions regarding false positives, the consequent diagnosis, and the risk of radiation, in addition to the added cost.
Conclusions
Randomized clinical trials evaluating the effectiveness of lung cancer screening have shown reduced mortality from lung cancer. Further research is needed to optimize the approach to LDCT screening but we argue that the implantation of screening in high-risk individuals should be implemented.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.