New diagnostic techniques for lung cancer
Advanced Thoracic Surgery, Akademisyen Kitabevi, ss.625-63, 2021
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2021
- Yayınevi: Akademisyen Kitabevi
- Sayfa Sayıları: ss.625-63
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Lung cancer is the most common type of cancer worldwide and also the leading cause of death. Most diagnosed patients are only treated with palliative care. Therefore, screening tests for lung cancer are of great importance. Early detection of cancer is ideal for screening tests that are low-risk, easy to implement, and cost-effective. By targeting screening and early diagnosis with new methods, cancer can be detected at an early stage and surgical resection, the only therapeutic method, can be applied. Although there is no ideal lung cancer screening test, low-dose computed tomography is the most commonly used method. Biomarkers that can be detected in serum, plasma, or sputum are promising as effective and easily applicable screening methods for lung cancer in the future. The aim is to detect lung cancer at an early stage without clinical symptoms. Screening tests are generally recommended for elderly heavy smokers. A multidisciplinary team approach in lung cancer is a suitable approach for community screening.An ideal diagnostic method has the expected characteristics and findings to distinguish between patients with and without the disease for every laboratory test and imaging method. Sensitivity indicates the rate of positive (abnormal) results in patients with the disease, while specificity measures the percentage of negative (normal) results in patients without the disease. Generally, when an examination is needed for screening or ruling out a disease, the test with the highest sensitivity is more valuable and preferred. Currently, there are only a few comprehensive tests available. Multiple test results are usually examined among patients with and without a specific disease. While multiple normal results tend to convincingly rule out the disease, tests that yield all abnormal results tend to convincingly confirm the disease. Tests or procedures are performed when it is believed that the available information, history review, physical examination, and questions about previous tests are insufficient to answer.On the other hand, when it comes to screening, the population at risk should be carefully identified. The intelligent use of new information obtained from tests requires clinicians to be aware of the probability of the disease (pre-test probability) before performing the test and the ability of the recommended test or procedure to change these probabilities. Additionally, when screening tests should be easy to implement, fast, cost-effective, and reliable, while surgical treatment is still applicable to diagnose cancer.Recently, many initiatives have been made to define guidance principles for the selection of appropriate patients and tests for early disease detection. Ideally, the disease being examined should be prevalent enough to justify its detection. Secondly, it should be associated with significant morbidity or mortality if left untreated. Thirdly, there should be an effective treatment that can alter its natural course. Finally, the benefits of detection and treatment in a pre-symptomatic state should go beyond those obtained with treatment in an early symptomatic state. When these criteria are met, the issue is examined in terms of the availability of tests. An ideal screening test is one that has high sensitivity, meaning that its results are abnormal in almost all individuals with the disease, and therefore provides confidence to the doctor that the patient is disease-free when the results are average. Specificity is also important due to the number of false-positive results obtained in a population where most individuals do not have the disease when a test is applied to screen for the disease.Screening Using Imaging MethodsChest X-rayChest X-ray uses a minimal dose of ionizing radiation. It is used to evaluate the lungs, heart, and chest wall and can be useful in conjunction with the following symptoms: persistent cough, shortness of breath, fever, chest pain, or injury, as well as conditions such as pneumonia, emphysema, and cancer.