DETECCION TEMPRANA DEL CANCER DE PULMON

Los resultados de los actuales programas de cribado del cáncer de pulmón por tomografía computarizada helicoidal con baja dosis de radiación demuestran que mediante esta técnica se pueden detectar tumores en estadios tempranos manteniendo en un mínimo el número de procedimientos invasivos realizados sobre lesiones histológicamente benignas.

Autor:
Gorka Bastarrika Alemañ
Columnista Experto de SIIC

Institución:
Servicio de Radiología, Clínica Universitaria, Universidad de Navarra

Artículos publicados por Gorka Bastarrika Alemañ

Recepción del artículo
3 de Enero, 2006

Primera edición
28 de Abril, 2006

Segunda edición, ampliada y corregida
7 de Junio, 2021

DETECCION TEMPRANA DEL CANCER DE PULMON

Resumen
El cáncer de pulmón es la neoplasia con mayor índice de mortalidad en todo el mundo. Los programas de detección temprana de cáncer de pulmón que se realizaron en la década del ’70 empleando radiografía simple de tórax y citología de esputo no demostraron una reducción significativa de la mortalidad específica por esta enfermedad. Los avances tecnológicos (tomografía computarizada helicoidal de baja dosis de radiación) han hecho resurgir el interés por los programas de dertección sistemática y los resultados obtenidos hasta la fecha son esperanzadores: en fumadores asintomáticos esta técnica permite detectar una proporción alta de tumores resecables en estadio temprano. Sin embargo, es necesario que se desarrollen programas bien diseñados, basados en la colaboración multidisciplinaria, antes de recomendar el cribado del cáncer de pulmón mediante tomografía computarizada torácica de baja dosis de radiación a la población general.

Palabras clave
cribado, cáncer de pulmón, tomografía computarizada (TC), detección temprana

Artículo completo
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EARLY DETECTION OF LUNG CANCER: RADIOLOGIC PERSPECTIVE

Abstract
Lung cancer is the most lethal malignant neoplasm worldwide. Screening programs using sputum cytology and chest radiography that have been carried out along these past decades have failed to demonstrate any reduction of the mortality rate due to lung cancer. Nowadays, advances in new forms of technology (low-dose CT) have resuscitated the expectant interest in screening programs. This technique has been shown to have a higher sensitivity for small pulmonary nodules, which is the most common presentation of early lung cancer. Preliminary results of early lung cancer detection programs based on low-dose CT are promising: a high proportion of early non-symptomatic, resectable cancers has been demonstrated in asymptomatic smokers. Nevertheless, well-designed, collaborative studies are needed before obtaining definitive conclusions and making general recommendations to screen individuals at high risk.

Key words
Cancer screening, Computed tomography-CT, Lung neoplasms, CT, Lung neoplasms, diagnosis

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Oncología
Relacionadas: Bioquímica, Diagnóstico por Laboratorio, Neumonología

Enviar correspondencia a:
Gorka Bastarrika Alemañ, Servicio de Radiología, Clínica Universitaria, Universidad de Navarra, 31008, Avenida Pío XII 36, Pamplona, España

Patrocinio y reconocimiento:
A los profesionales que trabajan en el programa de detección precoz de cáncer de pulmón de la Universidad de Navarra.

Bibliografía del artículo
1. Alberg AJ, Samet JM. Epidemiology of lung cancer. Chest. 2003;123((1 Suppl)):21S-49S.
2. Bray F, Sankila R, Ferlay J, Parkin DM. Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer. 2002 Jan;38(1):99-166.
3. Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, et al. Cancer statistics, 2005. CA Cancer J Clin. 2005 Jan-Feb;55(1):10-30.
4. Lee PN, Fry JS, Forey BA. Trends in lung cancer, chronic obstructive lung disease, and emphysema death rates for England and Wales 1941-85 and their relation to trends in cigarette smoking. Thorax. 1990 Sep;45(9):657-65.
5. Tyczynski JE, Bray F, Parkin DM. Lung cancer in Europe in 2000: epidemiology, prevention, and early detection. Lancet Oncol. 2003 Jan;4(1):45-55.
6. Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics, 1998. CA Cancer J Clin. 1998 Jan-Feb;48(1):6-29.
7. McDonald JC, Liddell FD, Dufresne A, McDonald AD. The 1891-1920 birth cohort of Quebec chrysotile miners and millers: mortality 1976-88. Br J Ind Med. 1993 Dec;50(12):1073-81.
8. Coakley FV, Cohen MD, Johnson MS, Hanna MP, Gonin R. Use of sliding thin-slab maximum intensity projection in the detection of simulated pulmonary nodules. Radiology. 1996;201:S162.
9. Chovil A, Sutherland RB, Halliday M. Respiratory cancer in a cohort of nickel sinter plant workers. Br J Ind Med. 1981 Nov;38(4):327-33.
10. Pershagen G. The carcinogenicity of arsenic. Environ Health Perspect. 1981 Aug;40:93-100.
11. Oliphant L, McFadden RG. Lung cancer following therapy for Hodgkin's disease. Can Med Assoc J. 1985 Mar 1;132(5):533-5.
12. Ooi WL, Elston RC, Chen VW, Bailey-Wilson JE, Rothschild H. Increased familial risk for lung cancer. J Natl Cancer Inst. 1986 Feb;76(2):217-22.
13. Liddell FD. The interaction of asbestos and smoking in lung cancer. Ann Occup Hyg. 2001 Jul;45(5):341-56.
14. Lee PN. Relation between exposure to asbestos and smoking jointly and the risk of lung cancer. Occup Environ Med. 2001 Mar;58(3):145-53.
15. Ahrens W, Merletti F. A standard tool for the analysis of occupational lung cancer in epidemiologic studies. Int J Occup Environ Health. 1998 Oct-Dec;4(4):236-40.
16. Ihde DC. Chemotherapy of lung cancer. N Engl J Med. 1992 Nov 12;327(20):1434-41.
17. Ginsberg RJ, Vokes EE, Rosenzweig K. Non-small cell lung cancer. In: De Vita TD, Hellman S, Rosenberg SA, editors. Cancer Principles and practice of oncology. 6 ed. Philadelphia: Lippincott Williams & Wilkins; 2001.
18. Agustí García-Navarro C, Rosell Costa R. Tumores broncopulmonares. Medicina Interna Farreras-Rozman. 14 ed. Madrid: Harcourt, S.A.; 2000.
19. Carter SK. Chemotherapy of lung cancer. Semin Oncol. 1982 Dec;9(4 Suppl 1):40-55.
20. Shields TW, Higgins GA, Jr., Matthews MJ, Keehn RJ. Surgical resection in the management of small cell carcinoma of the lung. J Thorac Cardiovasc Surg. 1982 Oct;84(4):481-8.
21. Beadsmoore CJ, Screaton NJ. Classification, staging and prognosis of lung cancer. Eur J Radiol. 2003 Jan;45(1):8-17.
22. Lilienfield A, Archer PG, Burnett CH. An evaluation of radiologic and cytologic screening for the early detection of lung cancer: a cooperative pilot study of the American Cancer Society and the Veterans Administration. Cancer Res. 1966;26:2083-121.
23. Boucot KR, Weiss W. Is curable lung cancer detected by semiannual screening? Jama. 1973 Jun 4;224(10):1361-5.
24. Brett GZ. Earlier diagnosis and survival in lung cancer. Br Med J. 1969 Nov 1;4(678):260-2.
25. Nash FA, Morgan JM, Tomkins JG. South London Lung Cancer Study. Br Med J. 1968 Jun 22;2(607):715-21.
26. Flehinger BJ, Melamed MR, Zaman MB, Heelan RT, Perchick WB, Martini N. Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Memorial Sloan-Kettering study. Am Rev Respir Dis. 1984 Oct;130(4):555-60.
27. Frost JK, Ball WC, Jr., Levin ML, Tockman MS, Baker RR, Carter D, et al. Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. Am Rev Respir Dis. 1984 Oct;130(4):549-54.
28. Fontana RS, Sanderson DR, Taylor WF, Woolner LB, Miller WE, Muhm JR, et al. Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Mayo Clinic study. Am Rev Respir Dis. 1984 Oct;130(4):561-5.
29. Kubik A, Polak J. Lung cancer detection. Results of a randomized prospective study in Czechoslovakia. Cancer. 1986 Jun 15;57(12):2427-37.
30. Ebeling K, Nischan P. Screening for lung cancer--results from a case-control study. Int J Cancer. 1987 Aug 15;40(2):141-4.
31. Wilde J. A 10 year follow-up of semi-annual screening for early detection of lung cancer in the Erfurt County, GDR. Eur Respir J. 1989 Jul;2(7):656-62.
32. Society AC. Guidelines for cancer related check-up; 1980.
33. Radiology ACo. Policy statement: referral criteria for chest x-ray examinations. Chicago; 1982.
34. Institute NC. Cancer control objectives for the nation: 1985-2000. Washington DC: Public Health Services; 1986.
35. Fontana RS, Sanderson DR, Woolner LB, Taylor WF, Miller WE, Muhm JR, et al. Screening for lung cancer. A critique of the Mayo Lung Project. Cancer. 1991 Feb 15;67(4 Suppl):1155-64.
36. Marcus PM, Bergstralh EJ, Fagerstrom RM, Williams DE, Fontana R, Taylor WF, et al. Lung cancer mortality in the Mayo Lung Project: impact of extended follow-up. J Natl Cancer Inst. 2000 Aug 16;92(16):1308-16.
37. Muhm JR, Brown LR, Crowe JK, Sheedy PF, Hattery RR, Stephens DH. Comparison of whole lung tomography and computed tomography for detecting pulmonary nodules. AJR Am J Roentgenol. 1978;131:981-4.
38. Henschke CI, McCauley DI, Yankelevitz DF, Naidich DP, McGuinness G, Miettinen OS, et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet. 1999 Jul 10;354(9173):99-105.
39. Swensen SJ, Jett JR, Sloan JA, Midthun DE, Hartman TE, Sykes AM, et al. Screening for lung cancer with low-dose spiral computed tomography. Am J Respir Crit Care Med. 2002 Feb 15;165(4):508-13.
40. Diederich S, Wormanns D, Semik M, Thomas M, Lenzen H, Roos N, et al. Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology. 2002 Mar;222(3):773-81.
41. Sone S, Takashima S, Li F, Yang Z, Honda T, Maruyama Y, et al. Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet. 1998 Apr 25;351(9111):1242-5.
42. Kaneko M, Eguchi K, Ohmatsu H, Kakinuma R, Naruke T, Suemasu K, et al. Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography. Radiology. 1996 Dec;201(3):798-802.
43. Bastarrika G, Pueyo JC, Lozano MD, Montuenga L, Zulueta JJ. [Screening for lung cancer with low-dose spiral CT: results in 150 asymptomatic subjects]. Med Clin (Barc). 2003 Jun 14;121(2):41-7.
44. Henschke CI, Yankelevitz DF, Smith JP, Libby D, Pasmantier M, McCauley D, et al. CT screening for lung cancer Assessing a regimen's diagnostic performance. Clin Imaging. 2004 Sep-Oct;28(5):317-21.
45. Pastorino U, Bellomi M, Landoni C, De Fiori E, Arnaldi P, Picchio M, et al. Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results. Lancet. 2003 Aug 23;362(9384):593-7.
46. Yang ZG, Sone S, Li F, Takashima S, Maruyama Y, Honda T, et al. Visibility of small peripheral lung cancers on chest radiographs: influence of densitometric parameters, CT values and tumour type. Br J Radiol. 2001 Jan;74(877):32-41.
47. Sobue T, Suzuki T, Naruke T. A case-control study for evaluating lung-cancer screening in Japan. Japanese Lung-Cancer-Screening Research Group. Int J Cancer. 1992 Jan 21;50(2):230-7.
48. Henschke CI, Naidich DP, Yankelevitz DF, McGuinness G, McCauley DI, Smith JP, et al. Early lung cancer action project: initial findings on repeat screenings. Cancer. 2001 Jul 1;92(1):153-9.
49. Swensen SJ, Jett JR, Hartman TE, Midthun DE, Sloan JA, Sykes AM, et al. Lung cancer screening with CT: Mayo Clinic experience. Radiology. 2003 Mar;226(3):756-61.
50. Aberle DR, Gamsu G, Henschke CI, Naidich DP, Swensen SJ. A consensus statement of the Society of Thoracic Radiology: screening for lung cancer with helical computed tomography. J Thorac Imaging. 2001 Jan;16(1):65-8.
51. Patz EF, Jr., Goodman PC, Bepler G. Screening for lung cancer. N Engl J Med. 2000 Nov 30;343(22):1627-33.
52. Benson K, Hartz AJ. A comparison of observational studies and randomized, controlled trials. N Engl J Med. 2000 Jun 22;342(25):1878-86.
53. Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med. 2000 Jun 22;342(25):1887-92.
54. Hirsch FR, Bunn PA, Jr., Dmitrovsky E, Field JK, Franklin WA, Greenberg RE, et al. IV international conference on prevention and early detection of lung cancer, Reykjavik, Iceland, August 9-12, 2001. Lung Cancer. 2002 Sep;37(3):325-44.
55. Boughton B. Large screening trial launched by NCI. Lancet Oncol. 2002;3(11):647.
56. Hillman BJ, Gatsonis C, Sullivan DC. American College of Radiology Imaging Network: new national cooperative group for conducting clinical trials of medical imaging technologies. Radiology. 1999 Dec;213(3):641-5.
57. Henschke C, Yankelevitz DF, Smith JP, Miettinen OS. Screening for lung cancer: the early lung cancer action approach. Lung Cancer. 2002;35:143-8.
58. Bastarrika G, Garcia-Velloso MJ, Lozano MD, Montes U, Torre W, Spiteri N, et al. Early lung cancer detection using spiral computed tomography and positron emission tomography. Am J Respir Crit Care Med. 2005 Jun 15;171(12):1378-83.

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Oncología

Relacionadas:
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Diagnóstico por Laboratorio
Neumonología

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