Lung cancer screening in Brazil: recommendations from the Brazilian Society of Thoracic Surgery, Brazilian Thoracic Association, and Brazilian College of Radiology and Diagnostic Imaging
J Bras Pneumol. 2024 Mar 22;50(1):e20230233.
doi: 10.36416/1806-3756/e20230233.
eCollection 2024.
[Article in
English,
Portuguese]
Authors
Luiz Fernando Ferreira Pereira
1
, Ricardo Sales Dos Santos
2
3
, Daniel Oliveira Bonomi
4
, Juliana Franceschini
3
5
, Ilka Lopes Santoro
6
, André Miotto
7
, Thiago Lins Fagundes de Sousa
8
, Rodrigo Caruso Chate
9
, Bruno Hochhegger
10
, Artur Gomes Neto
11
, Airton Schneider
12
, César Augusto de Araújo Neto
3
13
, Dante Luiz Escuissato
14
, Gustavo Faibischew Prado
15
, Luciana Costa-Silva
16
, Mauro Musa Zamboni
17
18
, Mario Claudio Ghefter
2
19
, Paulo César Rodrigues Pinto Corrêa
20
, Pedro Paulo Teixeira E Silva Torres
21
, Ricardo Kalaf Mussi
22
, Valdair Francisco Muglia
23
, Irma de Godoy
24
, Wanderley Marques Bernardo
25
Affiliations
- 1 Serviço de Pneumologia, Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil.
- 2 Serviço de Cirurgia Torácica, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil.
- 3 Programa ProPulmão, SENAI CIMATEC e SDS Healthline, Salvador (BA) Brasil.
- 4 Departamento de Cirurgia Torácica, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil.
- 5 Fundação ProAR, Salvador (BA) Brasil.
- 6 Disciplina de Pneumologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil.
- 7 Disciplina de Cirurgia Torácica, Departamento de Cirurgia, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil.
- 8 Serviço de Pneumologia, Hospital Universitário Alcides Carneiro, Universidade Federal de Campina Grande - UFCG - Campina Grande (PB) Brasil.
- 9 Serviço de Radiologia, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil.
- 10 Department of Radiology, University of Florida, Gainesville (FL) USA.
- 11 Serviço de Cirurgia Torácica, Santa Casa de Misericórdia de Maceió, Maceió (AL) Brasil.
- 12 Serviço de Cirurgia Torácica, Hospital São Lucas, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil.
- 13 Departamento de Radiologia, Faculdade de Medicina da Bahia - UFBA - Salvador (BA) Brasil.
- 14 Departamento de Clínica Médica, Universidade Federal Do Paraná - UFPR - Curitiba (PR) Brasil.
- 15 Serviço de Pneumologia, Hospital Alemão Oswaldo Cruz, São Paulo (SP) Brasil.
- 16 Serviço de Diagnóstico por Imagem, Instituto Hermes Pardini, Belo Horizonte (MG) Brasil.
- 17 Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro (RJ) Brasil.
- 18 Centro Universitário Arthur Sá Earp Neto/Faculdade de Medicina de Petrópolis -UNIFASE - Petrópolis (RJ) Brasil.
- 19 Serviço de Cirurgia Torácica, Hospital do Servidor Público Estadual, São Paulo (SP) Brasil.
- 20 Disciplina de Pneumologia, Escola de Medicina, Universidade Federal de Ouro Preto - UFOP - Ouro Preto (MG) Brasil.
- 21 Serviço de Radiologia, Hospital Israelita Albert Einstein, Goiânia (GO) Brasil.
- 22 Serviço de Cirurgia Torácica, Hospital das Clínicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP) Brasil.
- 23 Departamento de Imagens Médicas, Oncologia e Hematologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - USP - Ribeirão Preto (SP) Brasil.
- 24 Disciplina de Pneumologia, Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu (SP) Brasil.
- 25 Faculdade de Medicina, Universidade de São Paulo - USP - São Paulo (SP) Brasil.
Abstract
Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.
MeSH terms
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Brazil / epidemiology
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Early Detection of Cancer / methods
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Humans
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Lung Neoplasms* / diagnosis
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Mass Screening
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Radiology*
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Thoracic Surgery*
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Tomography, X-Ray Computed / methods