Evidence map›Paper›PMID 31636130›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2019

Sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms: a systematic review.

Stephen H Bradley, Sarah Abraham, Matthew Ej Callister, Adam Grice, William T Hamilton, Rocio Rodriguez Lopez, Bethany Shinkins, Richard D Neal

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Biomarkers Suitable for Early Detection of Intrathoracic Cancers in Primary Care: A Systematic Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
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  20. New developments in the imaging of lung cancer.Breathe (Sheffield, England) · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Stephen H BradleyAcademic Unit of Primary Care, University of Leeds, Leeds.
Sarah AbrahamTest Evaluation Group.
Matthew Ej CallisterLeeds Teaching Hospitals NHS Trust, Leeds.
Adam GriceAcademic Unit of Primary Care, University of Leeds, Leeds.
William T HamiltonUniversity of Exeter, Exeter.
Rocio Rodriguez LopezTest Evaluation Group, Academic Unit of Health Economics, University of Leeds, Leeds.
Bethany ShinkinsTest Evaluation Group, Academic Unit of Health Economics, University of Leeds, Leeds.
Richard D NealAcademic Unit of Primary Care, University of Leeds, Leeds.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite increasing use of computed tomography (CT), chest X-ray remains the first-line investigation for suspected lung cancer in primary care in the UK. No systematic review evidence exists as to the sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms.

aimTo estimate the sensitivity of chest X-ray for detecting lung cancer in symptomatic people. DESIGN AND

settingA systematic review was conducted to determine the sensitivity of chest X-ray for the detection of lung cancer.

methodDatabases including MEDLINE, EMBASE, and the Cochrane Library were searched; a grey literature search was also performed.

resultsA total of 21 studies met the eligibility criteria. Almost all were of poor quality. Only one study had the diagnostic accuracy of chest X-ray as its primary objective. Most articles were case studies with a high risk of bias. Several were drawn from non-representative groups, for example, specific presentations, histological subtypes, or comorbidities. Only three studies had a low risk of bias. Two primary care studies reported sensitivities of 76.8% (95% confidence interval [CI] = 64.5 to 84.2%) and 79.3% (95% CI = 67.6 to 91.0%). One secondary care study reported a sensitivity of 79.7% (95% CI = 72.7 to 86.8%).

conclusionThough there is a paucity of evidence, the highest-quality studies suggest that the sensitivity of chest X-ray for symptomatic lung cancer is only 77% to 80%. GPs should consider if further investigation is necessary in high-risk patients who have had a negative chest X-ray.

Indexed as

Radiography, ThoracicEarly Detection of CancerHumansLung NeoplasmsSensitivity and Specificitydiagnostic imagingearly diagnosislung cancerprimary careX-rays

Identifiers

PMID31636130
PMCPMC6805164

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.