Comments”: “Application of low-dose CT screening can reduce cancer mortality”

We read the study by Xue Tang¹ and colleagues with great interest, in which they identified that low-dose CT (LDCT) screening for lung cancer is effective in reducing the mortality rate of lung cancer in high-risk smokers. This information is of great significance in the prevention and early diagnosis of lung cancer, providing strong evidence for formulating health policies. However, we believe there are still some deficits, and that stronger evidence should be included for drawing the cause and effect conclusion between LDCT screening and decrease of lung cancer mortality.

To begin with, the authors should take into consideration many other protective effects following LDCT screening. For example, smoking cessation is a well-known protective factor for reducing lung cancer mortality². Changes in lifestyle after the lung cancer diagnosis, such as smoking cessation, can also result in the decrease of lung cancer mortality. Furthermore, early treatment and intervention following early diagnosis by LDCT screening can also be a strong protective factor³. Therefore, more factors should be considered when exploring the cause and effect relationship between LDCT screening and low-dose cancer mortality.

Furthermore, population bias should be appropriately excluded. Candidates included in LDCT screening tend to receive more emphasis on their health condition. Therefore, other measures such as regular serological examination might be performed, which can also elevate the possibility of lung cancer diagnosis and decrease the mortality rate of lung cancer⁴. Therefore, population-based studies should be included in future meta-analyses.

REFERENCES

• ¹
  Tang, X. QU, G. Wang, L. Wu, W. and Sun, Y. Low-dose CT screening can reduce cancer mortality: A meta-analysis. Rev Assoc Med Bras 2019;65 (12)1508-1514.
• ²
  Tse, L. A. Lin, X. Li, W. Qiu, H. Chan, C. K. Wang, F., et al. Smoking cessation sharply reduced lung cancer mortality in a historical cohort of 3185 Chinese silicotic workers from 1981 to 2014. Br J Cancer 2018;119: 1557-62.
• ³
  Blandin Knight, S. Crosbie, P. A. Balata, H. Chudziak, J. Hussell, T. and Dive, C. Progress and prospects of early detection in lung cancer. Open Biol 2017;7.
• ⁴
  Tang, Z. M. Ling, Z. G. Wang, C. M. Wu, Y. B. and Kong, J. L. Serum tumor-associated autoantibodies as diagnostic biomarkers for lung cancer: A systematic review and meta-analysis. PLoS ONE 2017;12: e0182117.

Publication Dates

• Publication in this collection
  27 Feb 2020
• Date of issue
  2020