Do we know enough about the effect of low-dose computed tomography screening for lung cancer on mortality to act? An updated systematic review, meta-analysis and network meta-analysis of randomised controlled trials 2017 to 2021
dc.contributor.author | Duer, E | |
dc.contributor.author | Yang, H | |
dc.contributor.author | Robinson, S | |
dc.contributor.author | Grigore, B | |
dc.contributor.author | Sandercock, J | |
dc.contributor.author | Snowsill, T | |
dc.contributor.author | Griffin, E | |
dc.contributor.author | Peters, J | |
dc.contributor.author | Hyde, C | |
dc.date.accessioned | 2024-06-24T12:04:19Z | |
dc.date.issued | 2023-12-11 | |
dc.date.updated | 2024-06-21T11:35:43Z | |
dc.description.abstract | BACKGROUND: For people at high risk of lung cancer, low-dose computed tomography (LDCT) is proposed as a method to reduce mortality. METHODS: Our objective was to estimate the effect of LDCT lung cancer screening on mortality in high-risk populations. A systematic review of randomised controlled trials (RCTs) comparing LDCT screening programmes with usual care (no screening) or other imaging screening programme (such as chest X-ray (CXR)) was conducted. RCTs of CXR screening were additionally included in the network meta-analyses. Bibliographic sources including MEDLINE, Embase, Web of Science and the Cochrane Library were searched to January 2017, and then further extended to November 2021. All key review steps were done by two persons. Quality assessment used the Cochrane Risk of Bias tool. Meta-analyses were performed. RESULTS: Nine RCTs, with up to 12.3 years of follow-up from randomisation, were included in the direct meta-analysis, which showed that LDCT screening was associated with a statistically significant decrease in lung cancer mortality (pooled relative risk (RR) 0.86, 95% confidence interval [CI] 0.77 to 0.96). There was a statistically non-significant decrease in all-cause mortality (pooled RR 0.98, 95% CI 0.95 to 1.01). The statistical heterogeneity for both outcomes was minimal. Network meta-analysis including the nine RCTs in the direct meta-analysis plus two further RCTs comparing CXR with usual care confirmed the size of the effect of LDCT on lung cancer mortality and that this was very similar irrespective of whether the comparator was usual care or CXR screening. CONCLUSIONS: LDCT screening is effective in reducing lung cancer mortality in high-risk populations. The uncertainty of its effect on lung cancer mortality observed in 2018 has been much reduced with new trial results and updates to existing trials, emphasising the importance of updating systematic reviews. Although there are still a number of RCTs unreported or in progress, we predict that further evolution of summary mortality estimates is unlikely. The focus for debate now moves to resolving uncertainty about the cost-effectiveness of LDCT screening taking into account the balance between benefits and harms which occur in all screening programmes. | en_GB |
dc.description.sponsorship | National Institute for Health and Care Research (NIHR) | en_GB |
dc.format.extent | 26- | |
dc.format.medium | Electronic | |
dc.identifier.citation | Vol. 7(1), article 26 | en_GB |
dc.identifier.doi | https://doi.org/10.1186/s41512-023-00162-0 | |
dc.identifier.grantnumber | 14/151/07 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/136408 | |
dc.identifier | ORCID: 0000-0003-4241-7595 (Grigore, Bogdan) | |
dc.identifier | ORCID: 0000-0001-7406-2819 (Snowsill, Tristan) | |
dc.identifier | ORCID: 0000-0003-1778-3518 (Peters, Jaime) | |
dc.identifier | ScopusID: 12239637600 (Peters, Jaime) | |
dc.identifier | ORCID: 0000-0002-7349-0616 (Hyde, Chris) | |
dc.identifier | ScopusID: 57055205300 | 7005161276 (Hyde, Chris) | |
dc.identifier | ResearcherID: HTQ-3128-2023 (Hyde, Chris) | |
dc.language.iso | en | en_GB |
dc.publisher | BMC | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/38072977 | en_GB |
dc.rights | © The Author(s) 2023. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ | en_GB |
dc.subject | Early detection of cancer | en_GB |
dc.subject | Lung neoplasms | en_GB |
dc.subject | Mass screening | en_GB |
dc.subject | Review | en_GB |
dc.subject | Spiral computed | en_GB |
dc.subject | Systematic | en_GB |
dc.subject | Tomography | en_GB |
dc.subject | X-ray computed tomography | en_GB |
dc.title | Do we know enough about the effect of low-dose computed tomography screening for lung cancer on mortality to act? An updated systematic review, meta-analysis and network meta-analysis of randomised controlled trials 2017 to 2021 | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2024-06-24T12:04:19Z | |
dc.identifier.issn | 2397-7523 | |
exeter.article-number | 26 | |
exeter.place-of-publication | England | |
dc.description | This is the final version. Available on open access from BMC via the DOI in this record | en_GB |
dc.description | Availability of data and materials: Data sharing not applicable to this article as no datasets were generated or analysed during the current study. | en_GB |
dc.identifier.eissn | 2397-7523 | |
dc.identifier.journal | Diagnostic and Prognostic Research | en_GB |
dc.relation.ispartof | Diagn Progn Res, 7(1) | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2023-10-16 | |
dc.rights.license | CC BY | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2023-12-11 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2024-06-24T11:57:16Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2024-06-24T12:04:31Z | |
refterms.panel | A | en_GB |
refterms.dateFirstOnline | 2023-12-11 |
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