2019
DOI: 10.21037/jtd.2019.08.66
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Recommendations for lung cancer screening in Southern Africa

Abstract: Lung cancer remains the leading cause of cancer-related deaths in southern Africa. Early trials of chest radiograph-based screening in males at high risk for lung cancer found no mortality benefit of a radiograph alone, or a radiograph plus sputum cytology screening strategy. Large prospective studies, including the National Lung Screening Trial, have shown an all-cause mortality benefit when lowdose computed tomography (LDCT) was used as a screening modality in patients that are at high risk of developing lun… Show more

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Cited by 18 publications
(20 citation statements)
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“…In 2015, the European Society of Radiology and the European Respiratory Society issued a white paper with lung cancer screening recommendations like that issued by the United States Preventive Services Task Force, recommending LDCT among highrisk individuals, defined as current or former (quit within the past 15 years) smokers aged 55-80 years with a 30 pack-year history of tobacco use (Kauczor et al, 2015). South Africa has recently issued a similar statement on lung cancer screening (Koegelenberg et al, 2019). Uptake of LDCT in high-income countries with the resources to implement population-based lung cancer screening is low (Li et al, 2018;Rai et al, 2019).…”
Section: Introductionmentioning
confidence: 99%
“…In 2015, the European Society of Radiology and the European Respiratory Society issued a white paper with lung cancer screening recommendations like that issued by the United States Preventive Services Task Force, recommending LDCT among highrisk individuals, defined as current or former (quit within the past 15 years) smokers aged 55-80 years with a 30 pack-year history of tobacco use (Kauczor et al, 2015). South Africa has recently issued a similar statement on lung cancer screening (Koegelenberg et al, 2019). Uptake of LDCT in high-income countries with the resources to implement population-based lung cancer screening is low (Li et al, 2018;Rai et al, 2019).…”
Section: Introductionmentioning
confidence: 99%
“…The authors suggested that a high prevalence of pulmonary nodules challenged diagnosing and staging lung cancer with screening, and proposed a nodule management protocol adapted to TB-endemic settings 52 . Accordingly, the Southern Africa Thoracic Society guidelines, published in 2019, endorsed a conservative cutoff for positive nodules considering the high local TB prevalence 53 . In Table 2, we compare the main US recommendations with the current LMIC guidelines 54,55 .…”
Section: Lcs In Lmicsmentioning
confidence: 99%
“…Adopting such protocols can also provide a simplified workflow for assessing positive findings and decrease the number of unnecessary follow-up CT scans, thus incurring less patient anxiety and lower costs 8,27 . Local nodule management guidelines are currently under validation in Asia 44,81 , Brazil 51 and South Africa 53 , considering diversities in local lung cancer epidemiology and aiming, in particular, to reduce false-positives in TB-endemic areas.…”
Section: Screening Delivery In Lmicsmentioning
confidence: 99%
“…Therefore, a CT scan of the chest may be of value in identifying malignancies hiding with the scar tissue. [8] …”
Section: Editorialmentioning
confidence: 99%
“…Therefore, a CT scan of the chest may be of value in identifying malignancies hiding with the scar tissue. [8] Patients with significant risk factors suggestive of 'scarcinoma' , namely previously documented lung scarring or old TB scarring, a family history suggestive of lung malignancies, a smoking history or an occupational history in the presence of unexplained weight loss and a chronic cough, with or without haemoptysis, need to be investigated further. The diagnostic tool of choice is debatable, but the use of biological imaging such as a positron emission tomography scan has added to our armamentarium in identifying the presence of a 'scarcinoma' .…”
mentioning
confidence: 99%