Low-dose computed tomography screening for lung cancer in populations highly exposed to tobacco: A systematic methodological appraisal of published randomised controlled trials

Coureau, Gaëlle; Salmi, Louis Rachid; Étard, C.; Sancho‐Garnier, H.; Sauvaget, Catherine; Mathoulin‐Pélissier, Simone

doi:10.1016/j.ejca.2016.04.006

Cited by 26 publications

(11 citation statements)

References 56 publications

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“…Non-calcified pulmonary nodules firstly detected during incidence screening may be entirely new (not present on a previous screen), not new (missed on a previous screen), or below the detection threshold of the respective LDCT lung cancer screening trial on the previous screen (hence, these are growing nodules). Unfortunately, lung cancer screening trials present their data concerning lung cancer rates in the various groups of non-calcified pulmonary nodules differently and the definitions of incidence nodules vary widely (4,5,10,16). The recently released British Thoracic Society Guidelines for the Investigation and Management of Pulmonary Nodules addresses this issue by stating that there is little evidence for the management of new incident nodules that appear on follow-up CTs (19).…”

Section: Review Articlementioning

confidence: 99%

“…Currently, lung cancer screening by LDCT is widely recommended for high-risk individuals by US guidelines (8)(9)(10)(11)(12)(13)(14)(15). However, there still is an ongoing debate if screening should be recommended for high-risk individuals in Europe, and further evidence is needed (16). Nevertheless, the vast data on (small) pulmonary nodules provided by the lung cancer screening trials enable further insights into the clinical management of pulmonary nodules and the development of…”

Section: Introductionmentioning

confidence: 99%

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Small pulmonary nodules in baseline and incidence screening rounds of low-dose CT lung cancer screening

Walter

Heuvelmans

Oudkerk

2017

Transl. Lung Cancer Res.

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Currently, lung cancer screening by low-dose computed tomography (LDCT) is widely recommended for high-risk individuals by US guidelines, but there still is an ongoing debate concerning respective recommendations for European countries. Nevertheless, the available data regarding pulmonary nodules released by lung cancer screening studies could improve future screening guidelines, as well as the clinical practice of incidentally detected pulmonary nodules on routine CT scans. Most lung cancer screening trials present results for baseline and incidence screening rounds separately, clustering pulmonary nodules initially found at baseline screening and newly detected pulmonary nodules after baseline screening together. This approach does not appreciate possible differences among pulmonary nodules detected at baseline and firstly detected at incidence screening rounds and is heavily influenced by methodological differences of the respective screening trials. This review intends to create a basis for assessing non-calcified pulmonary nodules detected during LDCT lung cancer screening in a more clinical relevant manner. The aim is to present data of non-calcified pulmonary baseline nodules and new non-calcified pulmonary incident nodules without clustering them together, thereby also simplifying translation to the clinical practice of incidentally detected pulmonary nodules. Small pulmonary nodules newly detected at incidence screening rounds of LDCT lung cancer screening may possess a greater lung cancer probability than pulmonary baseline nodules at a smaller size, which is essential for the development of new guidelines.

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Section: Review Articlementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Small pulmonary nodules in baseline and incidence screening rounds of low-dose CT lung cancer screening

Walter

Heuvelmans

Oudkerk

2017

Transl. Lung Cancer Res.

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“…The majority of these guidelines recommend low-dose chest CT lung cancer screening, but under strictly controlled conditions. In France, in 2014, a task force commissioned by the French National Authority for Health (HAS) conducted a review of the literature on the efficacy, acceptability and safety of low-dose chest CT lung cancer screening and concluded that the level of proof was insufficient to recommend a national lung cancer screening programme, as the benefit-risk balance was unknown 13. The most recent review of the literature on lung cancer screening, published in 2016, reached a similar conclusion that the benefit-risk balance of low-dose chest CT screening has not been correctly documented 14.…”

Section: Introductionmentioning

confidence: 99%

LUCSO-1—French pilot study of LUng Cancer Screening with low-dose computed tomography in a smokers population exposed to Occupational lung carcinogens: study protocol

et al. 2019

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IntroductionGuidelines concerning the follow-up of subjects occupationally exposed to lung carcinogens, published in France in 2015, recommended the setting up of a trial of low-dose chest CT lung cancer screening in subjects at high risk of lung cancer.ObjectiveTo evaluate the organisation of low-dose chest CT lung cancer screening in subjects occupationally exposed to lung carcinogens and at high risk of lung cancer.Methods and analysisThis trial will be conducted in eight French departments by six specialised reference centres (SRCs) in occupational health. In view of the exploratory nature of this trial, it is proposed to test initially the feasibility and acceptability over the first 2 years in only two SRCs then in four other SRCs to evaluate the organisation. The target population is current or former smokers with more than 30 pack-years (who have quit smoking for less than 15 years), currently or previously exposed to International Agency for Research on Cancer group 1 lung carcinogens, and between the ages of 55 and 74 years. The trial will be conducted in the following steps: (1) identification of subjects by a screening invitation letter; (2) evaluation of occupational exposure to lung carcinogens; (3) evaluation of the lung cancer risk level and verification of eligibility; (4) screening procedure: annual chest CT scans performed by specialised centres and (5) follow-up of CT scan abnormalities.Ethics and disseminationThis protocol study has been approved by the French Committee for the Protection of Persons. The results from this study will be submitted to peer-reviewed journals and reported at suitable national and international meetings.Trial registration numberNCT03562052; Pre-results.

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“…Following the conclusions of the working group, a recent review of the literature on the effectiveness, acceptability and safety of lung cancer screening with LDCT in subjects highly exposed to tobacco determined, in regard to the lack of strong scientific evidence, that LDCT screening should not be recommended in subjects with high exposures to tobacco [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Medical follow-up of workers exposed to lung carcinogens: French evidence-based and pragmatic recommendations

Delva

Margery²,

Laurent

et al. 2017

BMC Public Health

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BackgroundThe aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to lung carcinogens.MethodsA critical synthesis of the literature was conducted. Occupational lung carcinogenic substances were listed and classified according to their level of lung cancer risk. A targeted screening protocol was defined.ResultsA clinical trial, National Lung Screnning Trial (NLST), showed the efficacy of chest CAT scan (CT) screening for populations of smokers aged 55–74 years with over 30 pack-years of exposure who had stopped smoking for less than 15 years. To propose screening in accordance with NLST criteria, and to account for occupational risk factors, screening among smokers and former smokers needs to consider the types of occupational exposure for which the risk level is at least equivalent to the risk of the subjects included in the NLST. The working group proposes an algorithm that estimates the relative risk of each occupational lung carcinogen, taking into account exposure to tobacco, based on available data from the literature.ConclusionGiven the lack of data on bronchopulmonary cancer (BPC) screening in occupationally exposed workers, the working group proposed implementing a screening experiment for bronchopulmonary cancer in subjects occupationally exposed or having been occupationally exposed to lung carcinogens who are confirmed as having high risk factors for BPC. A specific algorithm is proposed to determine the level of risk of BPC, taking into account the different occupational lung carcinogens and tobacco smoking at the individual level.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4114-1) contains supplementary material, which is available to authorized users.

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Low-dose computed tomography screening for lung cancer in populations highly exposed to tobacco: A systematic methodological appraisal of published randomised controlled trials

Cited by 26 publications

References 56 publications

Small pulmonary nodules in baseline and incidence screening rounds of low-dose CT lung cancer screening

Small pulmonary nodules in baseline and incidence screening rounds of low-dose CT lung cancer screening

LUCSO-1—French pilot study of LUng Cancer Screening with low-dose computed tomography in a smokers population exposed to Occupational lung carcinogens: study protocol

Medical follow-up of workers exposed to lung carcinogens: French evidence-based and pragmatic recommendations

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