Lung Cancer Screening: An Overview of Systematic Reviews_Chinese Journal of Evidence-Based Medicine

Authors：

 LIJiang ¹ , SUKai ² , HUANGYao ³ , LIFang ² , TANGWei ³ , WANGLe ¹ , HUANGHui-yao ¹ ,  DAIMin ¹

1. Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China;
2. Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China;
3. Diagnostic Imaging, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China;

Corresponding?author：

DAIMin, Email: daimin2002@hotmail.com

Keywords：

Lung cancer; Screening; Overview of systematic reviews; Risk of bias; Quality of evidence

DOI：

10.7507/1672-2531.20160119

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the risk of bias and reliability of conclusions of systematic reviews (SRs) of lung cancer screening. Methods We searched PubMed, EMbase, The Cochrane Library (Issue 2, 2016), Web of Knowledge, CBM, WanFang Data and CNKI to collect SRs of lung cancer screening from inception to February 29^th, 2016. The ROBIS tool was applied to assess the risk of bias of included SRs, and then GRADE system was used for evidence quality assessment of outcomes of SRs. Results A total of 11 SRs involving 5 outcomes (mortality, detection rate, survival rate, over-diagnosis and potential benefits and harms) were included. The results of risk of bias assessment by ROBIS tool showed:Two studies completely matched the 4 questions of phase 1. In the phase 2, 6 studies were low risk of bias in the including criteria field; 8 studies were low risk of bias in the literature search and screening field; 3 studies were low risk of bias in the data abstraction and quality assessment field; and 5 studies were low risk of bias in the data synthesis field. In the phase 3 of comprehensive risk of bias results, 5 studies were low risk. The results of evidence quality assessment by GRADE system showed:three studies had A level evidence on the outcome of mortality; 1 study had A level evidence on detection; 1 study had A level evidence on survival rate; 3 studies on over-diagnosis had C level evidence; and 2 studies on potential benefits and harms had B level evidence. Conclusion The risk of bias of SRs of lung cancer screening is totally modest; however, the evidence quality of outcomes of these SRs is totally low. Clinicians should cautiously use these evidence to make decision based on local situation.

Citation： LIJiang, SUKai, HUANGYao, LIFang, TANGWei, WANGLe, HUANGHui-yao, DAIMin. Lung Cancer Screening: An Overview of Systematic Reviews. Chinese Journal of Evidence-Based Medicine, 2016, 16(7): 764-770. doi: 10.7507/1672-2531.20160119 Copy

1.	Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2):87-108.
2.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2):115-132.
3.	Black WC, Gareen IF, Soneji SS, et al. Cost-effectiveness of CT screening in the National Lung Screening Trial. N Engl J Med, 2014, 371(19):1793-1802.
4.	Aberle DR, Adams AM, Berg CD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 2011, 365(5):395-409.
5.	袁金秋, 劉雅莉, 楊克虎, 等. 系統評價再評價納入研究的質量評價方法調查. 中國循證醫學雜志, 2012, 12(2):238-242.
6.	Tammem?gi MC, Katki HA, Hocking WG, et al. Selection Criteria for Lung-Cancer Screening. N Engl J Med, 2013, 368(8):728-736.
7.	Moyer VA; U.S. Preventive Services Task Force. Screening for lung cancer:U.S. Preventive Services Task Force recommendation statement. Ann Intern Med, 2014, 160(5):330-338.
8.	Whiting P, Savovi? J, Higgins JP, et al. ROBIS group, ROBIS:A new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol, 2016, 69:225-234.
9.	Guyatt GH, Oxman AD, Vist GE, et al. GRADE:an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650):924-926.
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11.	Yau G, Lock M, Rodrigues G. Systematic review of baseline low-dose CT lung cancer screening. Lung Cancer, 2007, 58(2):161-170.
12.	Black C, de Verteuil R, Walker S, et al. Population screening for lung cancer using computed tomography, is there evidence of clinical effectiveness? A systematic review of the literature. Thorax, 2007, 62(2):131-138.
13.	Gopal M, Abdullah SE, Grady JJ, et al. Screening for lung cancer with low-dose computed tomography:a systematic review and meta-analysis of the baseline findings of randomized controlled trials. J Thorac Oncol, 2010, 5(8):1233-1239.
14.	尚文麗, 張和平, 楊拴盈, 等. 低劑量螺旋CT對高危人群肺癌篩查價值的Meta分析. 西安交通大學學報(醫學版), 2011, 32(1):38-42.
15.	惠珍珍. 低劑量CT與X線胸片對肺癌高危人群篩查的meta分析. 濟南:山東大學, 2011.
16.	Bach PB, Mirkin JN, Oliver TK, et al. Benefits and harms of CT screening for lung cancer:a systematic review. JAMA, 2012, 307(22):2418-2429.
17.	Chien CR, Liang JA, Chen JH, et al. Fluorodeoxyglucose-positron emission tomography screening for lung cancer:a systematic review and meta-analysis. Cancer Imaging, 2013, 13(4):458-465.
18.	Manser R, Lethaby A, Irving LB, et al. Screening for lung cancer. Cochrane Database Syst Rev, 2013, 6:CD001991.
19.	Humphrey L, Deffebach M, Pappas M, et al. Screening for Lung Cancer:Systematic Review to Update the U.S. Preventive Services Task Force Recommendation. Rockville (MD):Agency for Healthcare Research and Quality (US), 2013.
20.	Ollier M, Chamoux A, Naughton G, et al. Chest CT scan screening for lung cancer in asbestos occupational exposure:a systematic review and meta-analysis. Chest, 2014, 145(6):1339-1346.
21.	IOM (Institute of Medicine). Clinical Practice Guidelines We Can Trust. Washington, DC:The National Academies Press, 2011.
22.	陳耀龍, 楊克虎, 田金徽, 等. 循證實踐指南的制定:國際經驗與中國實踐. 蘭州大學學報(醫學版), 2016, 42(1):29-35.
23.	楊克虎, 劉雅莉, 袁金秋, 等. 發展和完善中的系統評價再評價. 中國循證兒科雜志, 2011, 6(1):54-57.
24.	田金徽, 陳耀龍, 楊克虎, 等. SR/MA研究進展與挑戰. 蘭州大學學報(醫學版), 2016, 42(1):42-46.
25.	熊俊, 陳日新. 系統評價/Meta分析方法學質量的評價工具AMSTAR. 中國循證醫學雜志, 2011, 11(9):1084-1089.
26.	吳瓊芳, 丁泓帆, 鄧圍, 等. ROBIS:評估系統評價偏倚風險的新工具. 中國循證醫學雜志, 2015, 15(12):1454-1457.
27.	丁泓帆, 吳瓊芳, 楊楠, 等. 評估系統評價偏倚風險的ROBIS工具實例解讀. 中國循證醫學雜志, 2016, 16(1):115-121.
28.	Available at:http://www.crd.york.ac.uk/PROSPERO.
29.	Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines:3. Rating the quality of evidence. J Clin Epidemiol, 2011, 64(4):401-406.

1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2):87-108.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2):115-132.
3. Black WC, Gareen IF, Soneji SS, et al. Cost-effectiveness of CT screening in the National Lung Screening Trial. N Engl J Med, 2014, 371(19):1793-1802.
4. Aberle DR, Adams AM, Berg CD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 2011, 365(5):395-409.
5. 袁金秋, 劉雅莉, 楊克虎, 等. 系統評價再評價納入研究的質量評價方法調查. 中國循證醫學雜志, 2012, 12(2):238-242.
6. Tammem?gi MC, Katki HA, Hocking WG, et al. Selection Criteria for Lung-Cancer Screening. N Engl J Med, 2013, 368(8):728-736.
7. Moyer VA; U.S. Preventive Services Task Force. Screening for lung cancer:U.S. Preventive Services Task Force recommendation statement. Ann Intern Med, 2014, 160(5):330-338.
8. Whiting P, Savovi? J, Higgins JP, et al. ROBIS group, ROBIS:A new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol, 2016, 69:225-234.
9. Guyatt GH, Oxman AD, Vist GE, et al. GRADE:an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650):924-926.
10. Manser RL, Irving LB, Byrnes G, et al. Screening for lung cancer:a systematic review and meta-analysis of controlled trials. Thorax, 2003, 58(9):784-789.
11. Yau G, Lock M, Rodrigues G. Systematic review of baseline low-dose CT lung cancer screening. Lung Cancer, 2007, 58(2):161-170.
12. Black C, de Verteuil R, Walker S, et al. Population screening for lung cancer using computed tomography, is there evidence of clinical effectiveness? A systematic review of the literature. Thorax, 2007, 62(2):131-138.
13. Gopal M, Abdullah SE, Grady JJ, et al. Screening for lung cancer with low-dose computed tomography:a systematic review and meta-analysis of the baseline findings of randomized controlled trials. J Thorac Oncol, 2010, 5(8):1233-1239.
14. 尚文麗, 張和平, 楊拴盈, 等. 低劑量螺旋CT對高危人群肺癌篩查價值的Meta分析. 西安交通大學學報(醫學版), 2011, 32(1):38-42.
15. 惠珍珍. 低劑量CT與X線胸片對肺癌高危人群篩查的meta分析. 濟南:山東大學, 2011.
16. Bach PB, Mirkin JN, Oliver TK, et al. Benefits and harms of CT screening for lung cancer:a systematic review. JAMA, 2012, 307(22):2418-2429.
17. Chien CR, Liang JA, Chen JH, et al. Fluorodeoxyglucose-positron emission tomography screening for lung cancer:a systematic review and meta-analysis. Cancer Imaging, 2013, 13(4):458-465.
18. Manser R, Lethaby A, Irving LB, et al. Screening for lung cancer. Cochrane Database Syst Rev, 2013, 6:CD001991.
19. Humphrey L, Deffebach M, Pappas M, et al. Screening for Lung Cancer:Systematic Review to Update the U.S. Preventive Services Task Force Recommendation. Rockville (MD):Agency for Healthcare Research and Quality (US), 2013.
20. Ollier M, Chamoux A, Naughton G, et al. Chest CT scan screening for lung cancer in asbestos occupational exposure:a systematic review and meta-analysis. Chest, 2014, 145(6):1339-1346.
21. IOM (Institute of Medicine). Clinical Practice Guidelines We Can Trust. Washington, DC:The National Academies Press, 2011.
22. 陳耀龍, 楊克虎, 田金徽, 等. 循證實踐指南的制定:國際經驗與中國實踐. 蘭州大學學報(醫學版), 2016, 42(1):29-35.
23. 楊克虎, 劉雅莉, 袁金秋, 等. 發展和完善中的系統評價再評價. 中國循證兒科雜志, 2011, 6(1):54-57.
24. 田金徽, 陳耀龍, 楊克虎, 等. SR/MA研究進展與挑戰. 蘭州大學學報(醫學版), 2016, 42(1):42-46.
25. 熊俊, 陳日新. 系統評價/Meta分析方法學質量的評價工具AMSTAR. 中國循證醫學雜志, 2011, 11(9):1084-1089.
26. 吳瓊芳, 丁泓帆, 鄧圍, 等. ROBIS:評估系統評價偏倚風險的新工具. 中國循證醫學雜志, 2015, 15(12):1454-1457.
27. 丁泓帆, 吳瓊芳, 楊楠, 等. 評估系統評價偏倚風險的ROBIS工具實例解讀. 中國循證醫學雜志, 2016, 16(1):115-121.
28. Available at:http://www.crd.york.ac.uk/PROSPERO.
29. Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines:3. Rating the quality of evidence. J Clin Epidemiol, 2011, 64(4):401-406.

Chinese Journal of Evidence-Based Medicine

Lung Cancer Screening: An Overview of Systematic Reviews

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