http://www.uptodate.com/contents/screening-for-lung-cancer
注意文章說的是高風險人群(估計是老煙槍之類的)的screening。即使這樣,假陽性有96%之高,就是片子有問題的人絕大多數沒有肺癌,是虛驚一場。這其中11%經曆了侵入性檢查(估計大多數都是不必要的)。在非高危人群裏假陽性應該更高。所以說用圖像篩檢肺癌的特異性很差。
Consequences of evaluating abnormal findings – Detection of abnormalities that require further evaluation, most of which are benign nodules. Evaluation may involve needle biopsy and/or surgery, with associated morbidity and mortality [21,22]. In the National Lung Screening Trial (NLST), over 53,000 high-risk individuals were randomly assigned to low-dose computerized tomography (LDCT) scan or chest radiograph screening [23]. Among abnormal results (24.2 percent of LDCT scans and 6.9 percent of radiographs), 96 percent were false-positive (that is, did not lead to a diagnosis of lung cancer) and 11 percent of the positive results led to an invasive study. Most positive studies are resolved with imaging and prove to be false-positive exams.