Journal of the Korean Medical Association (대한의사협회지)

Korean Medical Association (대한의사협회)
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The Korean guideline for lung cancer screening

폐암 검진 권고안

  • Jang, Seung Hun (Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University College of Medicine) ;
  • Sheen, Seungsoo (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Kim, Hyae Young (Department of Radiology, National Cancer Center) ;
  • Yim, Hyeon Woo (Department of Preventive Medicine, The Catholic University of Korea College of Medicine) ;
  • Park, Bo Young (Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Kim, Jae Woo (National Cancer Control Institute, National Cancer Center) ;
  • Park, In Kyu (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Young Whan (Division of Pulmonary and Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Lee, Kye Young (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Lee, Kyung Soo (Department of Radiology, Sungkyunkwan University School of Medicine) ;
  • Lee, Jong Mog (Department of Thoracic and Cardiovascular Surgery, National Cancer Center) ;
  • Hwangbo, Bin (Department of Pulmonology, National Cancer Center) ;
  • Paik, Sang Hyun (Department of Radiology, Soon Chun Hyang University Bucheon Hospital) ;
  • Kim, Jin-Hwan (Department of Radiology, Chungnam National University School of Medicine) ;
  • Sung, Nak Jin (Department of Family Medicine, Dongguk University College of Medicine) ;
  • Lee, Sang-hyun (Department of Family Medicine, National Health Insurance Service Ilsan Hospital) ;
  • Hwang, Seung-sik (Department of Social and Preventive Medicine, Inha University School of Medicine) ;
  • Kim, Soo Young (Department of Family Medicine, Hallym University College of Medicine) ;
  • Kim, Yeol (National Cancer Control Institute, National Cancer Center) ;
  • Lee, Won-Chul (Department of Preventive Medicine, The Catholic University of Korea College of Medicine) ;
  • Sung, Sook-Whan (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
  • 장승훈 (한림대학교 의과대학 호흡기-알레르기내과) ;
  • 신승수 (아주대학교 의과대학 호흡기내과) ;
  • 김혜영 (국립암센터 폐암센터 영상의학과) ;
  • 임현우 (가톨릭대학교 의과대학 예방의학교실) ;
  • 박보영 (국립암센터 국제암대학원대학교) ;
  • 김재우 (국립암센터 암검진사업과) ;
  • 박인규 (서울대학교 의과대학 서울대학교병원 흉부외과) ;
  • 김영환 (서울대학교 의과대학 서울대학교병원 호흡기내과) ;
  • 이계영 (건국대학교 의과대학 내과) ;
  • 이경수 (성균관대학교 의과대학 영상의학과, 국립암센터) ;
  • 이종목 (성균관대학교 의과대학, 흉부외과) ;
  • 황보빈 (성균관대학교 의과대학, 호흡기내과) ;
  • 백상현 (순천향대학교 부천병원 영상의학과) ;
  • 김진환 (충남대학교 의과대학 영상의학과) ;
  • 성낙진 (동국대학교 의과대학 가정의학과) ;
  • 이상현 (국민건강보험 일산병원 가정의학과) ;
  • 황승식 (인하대학교 의과대학 예방의학과) ;
  • 김수영 (한림대학교 의과대학 가정의학과) ;
  • 김열 (국립암센터 암검진사업과) ;
  • 이원철 (가톨릭대학교 의과대학 예방의학교실) ;
  • 성숙환 (가톨릭대학교 의과대학 흉부외과)
  • Received : 2015.03.02
  • Accepted : 2015.03.16
  • Published : 2015.04.10
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Abstract

Lung cancer is the leading cause of cancer death in many countries, including Korea. The majority of patients are inoperable at the time of diagnosis because symptoms are typically manifested at an advanced stage. A recent large clinical trial demonstrated significant reduction in lung cancer mortality by using low dose computed tomography (LDCT) screening. A Korean multisociety collaborative committee systematically reviewed the evidences regarding the benefits and harms of lung cancer screening, and developed an evidence-based clinical guideline. There is high-level evidence that annual screening with LDCT can reduce lung cancer mortality and all-cause mortality of high-risk individuals. The benefits of LDCT screening are modestly higher than the harms. Annual LDCT screening should be recommended to current smokers and ex-smokers (if less than 15 years have elapsed after smoking cessation) who are aged 55 to 74 years with 30 pack-years or more of smoking-history. LDCT can discover non-calcified lung nodules in 20 to 53% of the screened population, depending on the nodule positivity criteria. Individuals may undergo regular LDCT follow-up or invasive diagnostic procedures that lead to complications. Radiation-associated malignancies associated with repetitive LDCT, as well as overdiagnosis, should be considered the harms of screening. LDCT should be performed in qualified hospitals and interpreted by expert radiologists. Education and actions to stop smoking must be offered to current smokers. Chest radiograph, sputum cytology at regular intervals, and serum tumor markers should not be used as screening methods. These guidelines may be amended based on several large ongoing clinical trial results.

Keywords

References

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