Short URL: openmetaanalysis.github.io/lung-cancer-screening

This is a pre-print of an article published in the Journal of General Internal Medicine. The final authenticated version is available online at: https://doi.org/10.1007/s11606-020-05951-7.

View the Project on GitHub (for authors)

Clinical summary: This meta-analysis suggests that the clinical intervention is effectivefor reducing lung cancer mortality, though not for reducing overall mortality; Subgroup analyses suggest that there might be greater benefit for women than men, but findings are not statistically significant. Meta-regression indicates no significant modulators among study design or clinical factors. The heterogeneity was 'unimportant' (residual I2 = 0%).

The quality of evidence supporting benefit is high. We included randomized controlled trials of screening for lung cancer with LDCT. Additional interpretations may be in the references in the 'Cited by' section below.

Acknowledgement: we acknowledge the essential work by the authors of the prior systematic review(s) listed below.

Methods overview: This repository is an openMetaAnalysis that combines methods of scoping, rapid, and living systematic reviews. This analysis updates one or more previously published review(s)(1).

  Newer studies included are listed in the references. Rationale for newer trials excluded may be listed at the end of the references.

A comparison of studies included in this review compared to prior reviews are in the table, reconciliation of studies included with prior meta-analyses. Studies were abstacted into standardized tables of , and results.

Results: Details of the studies included are in the:

Below is the forest plot for the primary outcome. Additional Forest plots may be available. Image of forest plot of primary outcome

The Summary of Findings Table (SoF) from the GRADE Profile is below (source files). Image of GRADE Summary of findings table

References:

Systematic review(s)

Most recent review(s) at time of last revision of this repository

  1. 1: Huang KL, Wang SY, Lu WC, Chang YH, Su J, Lu YT. Effects of low-dose computed tomography on lung cancer screening: a systematic review, meta-analysis, and trial sequential analysis. BMC Pulm Med. 2019 Jul 11;19(1):126. PMID: [31296196](http://pubmed.gov/31296196). 2: Rota M, Pizzato M, La Vecchia C, Boffetta P. Efficacy of lung cancer screening appears to increase with prolonged intervention: results from the MILD trial and a meta-analysis. Ann Oncol. 2019 May 2. PMID: [31046087](http://pubmed.gov/31046087). 3: Wang X, Liu H, Shen Y, Li W, Chen Y, Wang H. Low-dose computed tomography (LDCT) versus other cancer screenings in early diagnosis of lung cancer: A meta-analysis. Medicine (Baltimore). 2018 Jul;97(27):e11233. PMID: [29979385](http://pubmed.gov/29979385). 4: Snowsill T, Yang H, Griffin E, Long L, Varley-Campbell J, Coelho H, Robinson S, Hyde C. Low-dose computed tomography for lung cancer screening in high-risk populations: a systematic review and economic evaluation. Health Technol Assess. 2018 Nov;22(69):1-276. doi: 10.3310/hta22690. PMID: [30518460](http://pubmed.gov/30518460) 5: Usman Ali M, Miller J, Peirson L, Fitzpatrick-Lewis D, Kenny M, Sherifali D, Raina P. Screening for lung cancer: A systematic review and meta-analysis. Prev Med. 2016 Aug;89:301-314. doi: 10.1016/j.ypmed.2016.04.015. Epub 2016 Apr 26. PMID: 27130532. 6: Coureau G, Salmi LR, Etard C, Sancho-Garnier H, Sauvaget C, Mathoulin-Pélissier S. Low-dose computed tomography screening for lung cancer in populations highly exposed to tobacco: A systematic methodological appraisal of published randomised controlled trials. Eur J Cancer. 2016 Jul;61:146-56. doi: 10.1016/j.ejca.2016.04.006. PMID: 27211572.

Studies

New Studies not included in the most recent review above

  1. 1: de Koning HJ, van der Aalst CM, de Jong PA, Scholten ET, Nackaerts K, Heuvelmans MA, et al. Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial. N Engl J Med. 2020 Feb 6;382(6):503-513. doi: 10.1056/NEJMoa1911793. PMID: 31995683.

Studies included in the most recent review above

  1. Becker N, Motsch E, Trotter A, Heussel CP, Dienemann H, Schnabel PA, Kauczor HU, Maldonado SG, Miller AB, Kaaks R, Delorme S. Lung cancer mortality reduction by LDCT screening-Results from the randomized German LUSI trial. Int J Cancer. 2020 Mar 15;146(6):1503-1513. doi: 10.1002/ijc.32486. Epub 2019 Jun 20. PubMed PMID: 31162856. Pastorino U, Silva M, Sestini S, Sabia F, Boeri M, Cantarutti A, Sverzellati N, Sozzi G, Corrao G, Marchianò A. Prolonged lung cancer screening reduced 10-year mortality in the MILD trial: new confirmation of lung cancer screening efficacy. Ann Oncol. 2019 Jul 1;30(7):1162-1169. doi: 10.1093/annonc/mdz117. Erratum in: Ann Oncol. 2019 Oct 1;30(10):1672. PubMed PMID: 30937431; PubMed Central PMCID: PMC6637372. Doroudi M, Pinsky PF, Marcus PM. Lung Cancer Mortality in the Lung Screening Study Feasibility Trial. JNCI Cancer Spectr. 2018 Sep 18;2(3):pky042. doi: 10.1093/jncics/pky042. eCollection 2018 Jul. PubMed PMID: 31360863; PubMed Central PMCID: PMC6649695. Yang W, Qian F, Teng J, Wang H, Manegold C, Pilz LR, Voigt W, Zhang Y, Ye J, Chen Q, Han B; Written on behalf of the AME Thoracic Surgery Collaborative Group. Community-based lung cancer screening with low-dose CT in China: Results of the baseline screening. Lung Cancer. 2018 Mar;117:20-26. doi: 10.1016/j.lungcan.2018.01.003. Epub 2018 Jan 11. PubMed PMID: 29496251. Paci E, Puliti D, Lopes Pegna A, Carrozzi L, Picozzi G, Falaschi F, Pistelli F, Aquilini F, Ocello C, Zappa M, Carozzi FM, Mascalchi M; the ITALUNG Working Group. Mortality, survival and incidence rates in the ITALUNG randomised lung cancer screening trial. Thorax. 2017 Sep;72(9):825-831. doi: 10.1136/thoraxjnl-2016-209825. Epub 2017 Apr 4. PubMed PMID: 28377492. Wille MM, Dirksen A, Ashraf H, Saghir Z, Bach KS, Brodersen J, Clementsen PF, Hansen H, Larsen KR, Mortensen J, Rasmussen JF, Seersholm N, Skov BG, Thomsen LH, Tønnesen P, Pedersen JH. Results of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk Profiling. Am J Respir Crit Care Med. 2016 Mar 1;193(5):542-51. doi: 10.1164/rccm.201505-1040OC. PubMed PMID: 26485620. Infante M, Cavuto S, Lutman FR, Passera E, Chiarenza M, Chiesa G, Brambilla G, Angeli E, Aranzulla G, Chiti A, Scorsetti M, Navarria P, Cavina R, Ciccarelli M, Roncalli M, Destro A, Bottoni E, Voulaz E, Errico V, Ferraroli G, Finocchiaro G, Toschi L, Santoro A, Alloisio M; DANTE Study Group. Long-Term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography. Am J Respir Crit Care Med. 2015 May 15;191(10):1166-75. doi: 10.1164/rccm.201408-1475OC. PubMed PMID: 25760561. National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409. doi: 10.1056/NEJMoa1102873. Epub 2011 Jun 29.PMID: 21714641.

Studies undergoing review

  1. Sadate A, Occean BV, Beregi JP, Hamard A, Addala T, de Forges H, Fabbro-Peray P, Frandon J. Systematic review and meta-analysis on the impact of lung cancer screening by low-dose computed tomography. Eur J Cancer. 2020 Jul;134:107-114. doi: 10.1016/j.ejca.2020.04.035. Epub 2020 Jun 2. PMID: 32502939.

Studies excluded - selected list of important studies
  1. Spiro SG, Shah PL, Rintoul RC, George J, Janes S, Callister M, et al. Sequential screening for lung cancer in a high-risk group: randomised controlled trial: LungSEARCH: a randomised controlled trial of Surveillance using sputum and imaging for the EARly detection of lung Cancer in a High-risk group. Eur Respir J. 2019;54(4):1900581. doi: 10.1183/13993003.00581-2019. Print 2019 Oct.PMID: 31537697 Spiro SG, Hackshaw A, Lung SCG. Research in progress--LungSEARCH: a randomized controlled trial of surveillance for the early detection of lung cancer in a high-risk group. Thorax. 2016;71(1):91-3. doi: 10.1136/thoraxjnl-2015-207433. Epub 2015 Jul 2. PMID: 26138736 Sagawa M, Nakayama T, Tanaka M, Sakuma T, Sobue T, Group JS. A randomized controlled trial on the efficacy of thoracic CT screening for lung cancer in non-smokers and smokers of <30 pack-years aged 50-64 years (JECS study): research design. Japanese journal of clinical oncology. 2012;42(12):1219-21. doi: 10.1093/jjco/hys157. Epub 2012 Oct 5. PMID: 23042771 Blanchon T, Brechot JM, Grenier PA, Ferretti GR, Lemarie E, Milleron B, et al. Baseline results of the Depiscan study: a French randomized pilot trial of lung cancer screening comparing low dose CT scan (LDCT) and chest X-ray (CXR). Lung Cancer. 2007;58(1):50-8. doi: 10.1016/j.lungcan.2007.05.009. Epub 2007 Jul 12. PMID: 17624475 Field JK, Duffy SW, Baldwin DR, Brain KE, Devaraj A, Eisen T, et al. The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer. Health Technol Assess. 2016;20(40):1-146. doi: 10.3310/hta20400.PMID: 27224642 Field JK, Duffy SW, Baldwin DR, Whynes DK, Devaraj A, Brain KE, et al. UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening. Thorax. 2016;71(2):161-70. doi: 10.1136/thoraxjnl-2015-207140. Epub 2015 Dec 8. PMID: 26645413 Garg K, Keith RL, Byers T, Kelly K, Kerzner AL, Lynch DA, et al. Randomized controlled trial with low-dose spiral CT for lung cancer screening: feasibility study and preliminary results. Radiology. 2002;225(2):506-10. doi: 10.1148/radiol.2252011851. PMID: 12409588

Funding for this review

  1. None.

Cited by

This repository is cited by:

  1. Hoffman RM, Atallah RP, Struble RD, Badgett RG. Lung Cancer Screening with Low-Dose CT: a Meta-Analysis. J Gen Intern Med. 2020 Oct;35(10):3015-3025. doi: 10.1007/s11606-020-05951-7. Epub 2020 Jun 24. PMID: 32583338; PMCID: PMC7573097.
  2. WikiDoc contributors. Pending. WikiDoc. Fef 24, 2015. Available at: http://www.wikidoc.org/index.php/Pending. Accessed February 24, 2015.