Overdiagnosis of lung cancer with low-dose computed tomography screening: meta-analysis of the randomised clinical trials

Publikation: Bidrag til tidsskriftReviewfagfællebedømt

Standard

Overdiagnosis of lung cancer with low-dose computed tomography screening : meta-analysis of the randomised clinical trials. / Brodersen, John; Voss, Theis; Martiny, Frederik; Siersma, Volkert; Barratt, Alexandra; Heleno, Bruno.

I: Breathe, Bind 16, Nr. 1, 200013, 2020.

Publikation: Bidrag til tidsskriftReviewfagfællebedømt

Harvard

Brodersen, J, Voss, T, Martiny, F, Siersma, V, Barratt, A & Heleno, B 2020, 'Overdiagnosis of lung cancer with low-dose computed tomography screening: meta-analysis of the randomised clinical trials', Breathe, bind 16, nr. 1, 200013. https://doi.org/10.1183/20734735.0013-2020

APA

Brodersen, J., Voss, T., Martiny, F., Siersma, V., Barratt, A., & Heleno, B. (2020). Overdiagnosis of lung cancer with low-dose computed tomography screening: meta-analysis of the randomised clinical trials. Breathe, 16(1), [200013]. https://doi.org/10.1183/20734735.0013-2020

Vancouver

Brodersen J, Voss T, Martiny F, Siersma V, Barratt A, Heleno B. Overdiagnosis of lung cancer with low-dose computed tomography screening: meta-analysis of the randomised clinical trials. Breathe. 2020;16(1). 200013. https://doi.org/10.1183/20734735.0013-2020

Author

Brodersen, John ; Voss, Theis ; Martiny, Frederik ; Siersma, Volkert ; Barratt, Alexandra ; Heleno, Bruno. / Overdiagnosis of lung cancer with low-dose computed tomography screening : meta-analysis of the randomised clinical trials. I: Breathe. 2020 ; Bind 16, Nr. 1.

Bibtex

@article{c930d2a5e67843cf807c3f386958c12d,
title = "Overdiagnosis of lung cancer with low-dose computed tomography screening: meta-analysis of the randomised clinical trials",
abstract = "In low-dose computed tomography (LDCT) screening for lung cancer, all three main conditions for overdiagnosis in cancer screening are present: 1) a reservoir of slowly or nongrowing lung cancer exists; 2) LDCT is a high-resolution imaging technology with the potential to identify this reservoir; and 3) eligible screening participants have a high risk of dying from causes other than lung cancer. The degree of overdiagnosis in cancer screening is most validly estimated in high-quality randomised controlled trials (RCTs), with enough follow-up time after the end of screening to avoid lead-time bias and without contamination of the control group.Nine RCTs investigating LDCT screening were identified. Two RCTs were excluded because lung cancer incidence after the end of screening was not published. Two other RCTs using active comparators were also excluded. Therefore, five RCTs were included: two trials were at low risk of bias, two of some concern and one at high risk of bias. In a meta-analysis of the two low risk of bias RCTs including 8156 healthy current or former smokers, 49% of the screen-detected cancers were overdiagnosed. There is uncertainty about this substantial degree of overdiagnosis due to unexplained heterogeneity and low precision of the summed estimate across the two trials.",
keywords = "CT, HARMS, MORTALITY, BENEFITS, GROWTH, IMPLEMENTATION, DESIGN",
author = "John Brodersen and Theis Voss and Frederik Martiny and Volkert Siersma and Alexandra Barratt and Bruno Heleno",
year = "2020",
doi = "10.1183/20734735.0013-2020",
language = "English",
volume = "16",
journal = "Breathe",
issn = "1810-6838",
publisher = "European Respiratory Society",
number = "1",

}

RIS

TY - JOUR

T1 - Overdiagnosis of lung cancer with low-dose computed tomography screening

T2 - meta-analysis of the randomised clinical trials

AU - Brodersen, John

AU - Voss, Theis

AU - Martiny, Frederik

AU - Siersma, Volkert

AU - Barratt, Alexandra

AU - Heleno, Bruno

PY - 2020

Y1 - 2020

N2 - In low-dose computed tomography (LDCT) screening for lung cancer, all three main conditions for overdiagnosis in cancer screening are present: 1) a reservoir of slowly or nongrowing lung cancer exists; 2) LDCT is a high-resolution imaging technology with the potential to identify this reservoir; and 3) eligible screening participants have a high risk of dying from causes other than lung cancer. The degree of overdiagnosis in cancer screening is most validly estimated in high-quality randomised controlled trials (RCTs), with enough follow-up time after the end of screening to avoid lead-time bias and without contamination of the control group.Nine RCTs investigating LDCT screening were identified. Two RCTs were excluded because lung cancer incidence after the end of screening was not published. Two other RCTs using active comparators were also excluded. Therefore, five RCTs were included: two trials were at low risk of bias, two of some concern and one at high risk of bias. In a meta-analysis of the two low risk of bias RCTs including 8156 healthy current or former smokers, 49% of the screen-detected cancers were overdiagnosed. There is uncertainty about this substantial degree of overdiagnosis due to unexplained heterogeneity and low precision of the summed estimate across the two trials.

AB - In low-dose computed tomography (LDCT) screening for lung cancer, all three main conditions for overdiagnosis in cancer screening are present: 1) a reservoir of slowly or nongrowing lung cancer exists; 2) LDCT is a high-resolution imaging technology with the potential to identify this reservoir; and 3) eligible screening participants have a high risk of dying from causes other than lung cancer. The degree of overdiagnosis in cancer screening is most validly estimated in high-quality randomised controlled trials (RCTs), with enough follow-up time after the end of screening to avoid lead-time bias and without contamination of the control group.Nine RCTs investigating LDCT screening were identified. Two RCTs were excluded because lung cancer incidence after the end of screening was not published. Two other RCTs using active comparators were also excluded. Therefore, five RCTs were included: two trials were at low risk of bias, two of some concern and one at high risk of bias. In a meta-analysis of the two low risk of bias RCTs including 8156 healthy current or former smokers, 49% of the screen-detected cancers were overdiagnosed. There is uncertainty about this substantial degree of overdiagnosis due to unexplained heterogeneity and low precision of the summed estimate across the two trials.

KW - CT

KW - HARMS

KW - MORTALITY

KW - BENEFITS

KW - GROWTH

KW - IMPLEMENTATION

KW - DESIGN

U2 - 10.1183/20734735.0013-2020

DO - 10.1183/20734735.0013-2020

M3 - Review

C2 - 32194774

VL - 16

JO - Breathe

JF - Breathe

SN - 1810-6838

IS - 1

M1 - 200013

ER -

ID: 245319046