Evidence map›Paper›PMID 31890897›Full record

ArticleDiagnostic and prognostic research2019

Do we know enough about the effect of low-dose computed tomography screening for lung cancer on survival to act? A systematic review, meta-analysis and network meta-analysis of randomised controlled trials.

Huiqin Yang, Jo Varley-Campbell, Helen Coelho, Linda Long, Sophie Robinson, Tristan Snowsill, Ed Griffin, Jaime Peters, Chris Hyde

Abstract read
In one paragraph

Article in Diagnostic and prognostic research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
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

9 authors.

Huiqin Yang1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.
Jo Varley-Campbell1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.
Helen Coelho1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.
Linda Long1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.
Sophie Robinson1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.
Tristan Snowsill1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.
Ed Griffin1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.
Jaime Peters1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.
Chris Hyde1Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.ORCID 0000-0002-7349-0616

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiagnosis of lung cancer frequently occurs in its later stages. Low-dose computed tomography (LDCT) could detect lung cancer early.

methodsOur objective was to estimate the effect of LDCT lung cancer screening on mortality in high-risk populations. A systematic review of randomised controlled trials (RCTs) comparing LDCT screening programmes with usual care (no screening) or other imaging screening programme (such as chest X-ray (CXR)) was conducted. RCTs of CXR screening were additionally included in the network meta-analysis. Bibliographic sources including MEDLINE, Embase, Web of Science and the Cochrane Library were searched to January 2017. All key review steps were done by two persons. Quality assessment used the Cochrane Risk of Bias tool. Meta-analyses were performed.

resultsFour RCTs were included. More will provide data in the future. Meta-analysis demonstrated that LDCT screening with up to 9.80 years of follow-up was associated with a statistically non-significant decrease in lung cancer mortality (pooled relative risk (RR) 0.94, 95% confidence interval (CI) 0.74 to 1.19;

conclusionsLDCT screening may be effective in reducing lung cancer mortality but there is considerable uncertainty: the largest of the RCTs compared LDCT with CXR screening rather than no screening; there is imprecision of the estimates; and there is important heterogeneity between the included study results. The uncertainty about the effect on all-cause mortality is even greater. Maturing trials may resolve the uncertainty.

Indexed as

Early detection of cancerLung neoplasmsMass screeningReview, SystematicTomography, Spiral computedTomography, X-ray computed

Identifiers

PMID31890897
PMCPMC6933743

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Registered trials

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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.