Low-dose CT for lung cancer screening in a high-risk population (SUMMIT): a prospective, longitudinal cohort study
Notice bibliographique
Résumé
BACKGROUND: Low-dose CT screening reduces lung cancer mortality. In advance of planned national lung cancer screening programmes, research is needed to inform policies regarding implementation. We aimed to assess the implementation of low-dose CT for lung cancer screening in a high-risk population and to validate a multicancer early detection blood test. METHODS: In this prospective, longitudinal cohort study, individuals aged 55-77 years recorded as current smokers in their primary care records at any point within the past 20 years were identified from 329 primary care practices in London (UK) and invited for a lung health check via postal letter. Individuals meeting the 2013 United States Preventive Services Taskforce criteria (current or former smokers within the past 15 years with at least 30 pack-year smoking histories) or having a Prostate, Lung, Colorectal and Ovarian 2012 model 6-year risk of 1·3% or greater, and not currently receiving treatment for an active cancer (except adjuvant hormonal therapy), were eligible for the study. These individuals underwent lung cancer screening via non-contrast, thin collimation low-dose CT. In this analysis, we report the results of the baseline round of low-dose CT screening. Key primary endpoints were those associated with examining the performance of a lung cancer screening service. Outcome measures were analysed on a per-participant level using descriptive frequencies. The study was registered with ClinicalTrials.gov, NCT03934866. FINDINGS: Between April 8, 2019, and May 14, 2021, 12 773 participants were recruited and analysed. 7353 (57·6%) of 12 773 participants were male and 5420 (42·4%) were female, and 10 665 (83·5%) participants were White. 261 (2·0%) of 12 773 participants were diagnosed with lung cancer (including 163 [1·3%] participants with screen-detected lung cancer and 98 [0·8%] with delayed screen-detected lung cancer [ie, after a 3-month or 6-month nodule follow-up CT]) and 276 (2·2%) participants were diagnosed with any intrathoracic malignancy after a positive baseline screen. 207 (79·3%) of 261 individuals with prevalent screen-detected lung cancer were diagnosed at stage I or II and surgical resection was the primary treatment modality in 201 (77·0%) of 261 individuals. Including cases where multiple resections were done in the same participant (eg, for synchronous primaries), 28 (11·6%) of 241 surgical resections were benign, and there was one (0·4%) death within 90 days of surgery. At 12 months, the episode sensitivity of our low-dose CT screening protocol for detecting lung cancer was 97·0% (95% CI 95·0-99·1; 261 of 269 participants). The specificity was 95·2% (94·8-95·6; 11 905 of 12 504 participants), with a false-positive rate of 4·8% (4·4-5·2). INTERPRETATION: Large-scale lung cancer screening is effective and can be delivered efficiently to an ethnically and socioeconomically diverse population. FUNDING: GRAIL.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».