Effectiveness of Lung Cancer Screening by Sex and Tumor Histology: Extended, Pooled Analysis of the ITALUNG and LUSI Trials, with Comparison to Findings in the NLST
Menée à partir de données de plusieurs essais évaluant le dépistage du cancer du poumon, cette étude évalue, en fonction du sexe, l'effet d'un dépistage par tomographie numérique à faible dose de rayonnement sur l'incidence de différents sous-types tumoraux et sur la mortalité associée
Randomized trials have shown that low-dose computed tomography (LDCT) screening can reduce lung cancer (LC)-related mortality, but questions remain about differences in screening effects by sex and/or tumor histology. The US National Lung Screening Trial (NLST) [1], the Dutch–Belgian Netherlands–Leuvens Longkanker Screenings Onderzoek study [2] and other randomized trials, including the German Lung Cancer Screening Intervention study (LUSI) [3] and the Italian Lung study (ITALUNG) [4], indicated a stronger LC-related mortality reduction in women than in men, although this heterogeneity was not statistically significant in any separate study. Only the NLST has, so far, examined the effects of LDCT screening on LC-related mortality by sex and histologic tumor subtype [1], showing an equal mortality reduction among men (risk ratio [RR] = 0.71) and women (RR = 0.70) for non-small-cell LC (NSCLC) of nonsquamous histology. For women only, NLST showed an additional, borderline significant mortality risk reduction (hazard ratio [HR] = 0.67; 95% confidence interval [CI]: 0.40 to 1.03) for small-cell LC (SCLC), which, however, was deemed a possible chance observation [1].
Cancer Communications , article en libre accès, 2026