국가폐암검진: 개요 및 영상 질 관리 = National Lung Cancer Screening in Korea: Introduction and Imaging Quality Control

다국어 초록 (Multilingual Abstract)

Before the implementation of lung cancer screening as a national cancer screening program, the Korean Lung Cancer Screening Project was performed to evaluate its effectiveness and feasibility.
A national lung cancer screening program with low-dose CT (LDCT) will begin from the second half of 2019. LDCT should be performed in high-risk subjects, aged 54–74 years, with a smoking history of 30 pack years or more. The use of multi-detector CT with a minimum of 16 channels is recommended, and LDCT scanning should be performed with the maximum CTDIvol radiation dose of 3 mGy in standard-sized subjects. The results of LDCT should be reported using the Lung CT Screening Reporting and Data System by diagnostic radiologists educated in specified programs. Radiologists play an important role in lung cancer screening. Quality control and reporting of LDCT is mandatory, and continued education is necessary. Cessation of smoking is the most important in lung cancer screening.

국문 초록 (Abstract)

국가암검진사업으로 폐암검진을 도입하기 전에 효과 및 타당성 평가를 위하여 국가폐암검진시범사업(Korean Lung Cancer Screening Project)이 진행되었고, 2019년 후반부터 국가폐암검진을 시작한다. 폐암 고위험군(만 54~74세, 흡연력 30갑년 이상)을 대상으로 저선량 CT 를 시행하며, 16열 이상의 CT로 표준체중 수검자에서 방사선 선량을 CTDIvol 3 mGy 이하로촬영해야 한다. 특정 교육을 이수한 영상의학과 전문의가 촬영을 관리 감독하고 저선량 CT를판독하여야 하고, 판독 표준화를 위하여 Lung CT Screening Reporting and Data System을사용한다. 폐암검진에 있어 영상의학과의 역할이 매우 중요하고, 저선량 CT 촬영 및 판독의질 관리가 필수적이며 지속적인 교육이 필요하다. 폐암검진에 있어 가장 중요한 것은 금연으로, 저선량 CT를 이용한 조기검진과 함께 수검자가 금연할 수 있도록 유도해야 한다.

참고문헌 (Reference)

1 장승훈, "폐암 검진 권고안" 대한의사협회 58 (58): 291-301, 2015

2 Godoy MCB, "Understanding lung-RADS 1.0: a case-based review" 39 : 260-272, 2018

3 Duffy SW, "Translation of research results to simple estimates of the likely effect of a lung cancer screening programme in the United Kingdom" 110 : 1834-1840, 2014

4 Minnix JA, "The importance of incorporating smoking cessation into lung cancer screening" 7 : 272-280, 2018

5 Moyer VA, "Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement" 160 : 330-338, 2014

6 Usman Ali M, "Screening for lung cancer : a systematic review and meta-analysis" 89 : 301-314, 2016

7 Mazzone PJ, "Screening for lung cancer : CHEST guideline and expert panel report" 153 : 954-985, 2018

8 Ministry of Health and Welfare, "Rules for the installation and operation of special medical equipment"

9 Field JK, "Risk assessment in relation to the detection of small pulmonary nodules" 6 : 35-41, 2017

10 National Lung Screening Trial Research Team, "Results of initial low-dose computed tomographic screening for lung cancer" 368 : 1980-1991, 2013

11 National Lung Screening Trial Research Team, "Reduced lung-cancer mortality with low-dose computed tomographic screening" 365 : 395-409, 2011

12 Becker N, "Randomized study on early detection of lung cancer with MSCT in Germany : study design and results of the first screening round" 138 : 1475-1486, 2012

13 이지원, "Radiological Report of Pilot Study for the Korean Lung Cancer Screening (K-LUCAS) Project: Feasibility of Implementing Lung Imaging Reporting and Data System" 대한영상의학회 19 (19): 803-808, 2018

14 Brenner DJ, "Radiation risks potentially associated with low-dose CT screening of adult smokers for lung cancer" 231 : 440-445, 2004

15 McCunney RJ, "Radiation risks in lung cancer screening programs" 145 : 618-624, 2014

16 Jacobs PC, "Prevalence of incidental findings in computed tomographic screening of the chest : a systematic review" 32 : 214-221, 2008

17 Pinsky PF, "Performance of lung-RADS in the national lung screening trial : a retrospective assessment" 162 : 485-491, 2015

18 Patz EF Jr, "Overdiagnosis in low-dose computed tomography screening for lung cancer" 174 : 269-274, 2014

19 Van de Wiel JC, "Neglectable benefit of searching for incidental findings in the Dutch-Belgian lung cancer screening trial(NELSON)using low-dose multidetector CT" 17 : 1474-1482, 2007

20 Ko JP, "Management of incidental lung nodules" 39 : 249-259, 2018

21 Silva M, "Lung cancer screening with low-dose CT in Europe : strength and weakness of diverse independent screening trials" 72 : 389-400, 2017

22 Pinsky PF, "Lung cancer screening with low-dose CT : a world-wide view" 7 : 234-242, 2018

23 Mascalchi M, "Lung cancer screening with low dose CT and radiation harm-from prediction models to cancer incidence data" 5 : 360-, 2017

24 American Association of Physicists in Medicine, "Lung cancer screening protocols version 5.0"

25 American College of Radiology, "Lung Cancer Screening Registry (LCSR)"

26 American College of Radiology, "Lung CT screening reporting & data system"

27 American College of Radiology, "Lung CT Screening Reporting & Data System 2019. Lung‐RADS® Version 1.1"

28 Sone S, "Long-term follow-up study of a population-based 1996-1998 mass screening programme for lung cancer using mobile low-dose spiral computed tomography" 58 : 329-341, 2007

29 Infante M, "Long-term follow-up results of the DANTE trial, a randomized study of lung cancer screening with spiral computed tomography" 191 : 1166-1175, 2015

30 Tsai EB, "Incidental findings on lung cancer screening : significant and management" 39 : 273-281, 2018

31 Oudkerk M, "European position statement on lung cancer screening" 18 : e754-e766, 2017

32 Veronesi G, "Estimating overdiagnosis in low-dose computed tomography screening for lung cancer : a cohort study" 157 : 776-784, 2012

33 이재호, "Development of Protocol for Korean Lung Cancer Screening Project (K-LUCAS) to Evaluate Effectiveness and Feasibility to Implement National Cancer Screening Program" 대한암학회 51 (51): 1285-1294, 2019

34 Horeweg N, "Detection of lung cancer through low-dose CT screening(NELSON) : a prespecified analysis of screening test performance and interval cancers" 15 : 1342-1350, 2014

35 Centers for Medicare & Medicaid Services, "Decision memo for screening for lung cancer with low dose computed tomography (LDCT) (CAG-00439N)"

36 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2016" 대한암학회 51 (51): 417-430, 2019

37 Saghir Z, "CT screening for lung cancer brings forward early disease. The randomised Danish Lung Cancer Screening Trial: status after five annual screening rounds with low-dose CT" 67 : 296-301, 2012

38 Bach PB, "Benefits and harms of CT screening for lung cancer : a systematic review" 307 : 2418-2429, 2012

39 Kucharczyk MJ, "Assessing the impact of incidental findings in a lung cancer screening study by using low-dose computed tomography" 62 : 141-145, 2011

40 한대희, "Are Lung Imaging Reporting and Data System Categories Clear to Radiologists? A Survey of the Korean Society of Thoracic Radiology Members on Ten Difficult-to-Classify Scenarios" 대한영상의학회 18 (18): 402-407, 2017