Radiološki probir karcinoma pluća

master's thesis

• Title (english): Lung cancer screening
• Author: Kristijan Kaniški
• Mentor: Maja Hrabak Paar (mentor)
• Committee member: Maja Prutki (predsjednik povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Committee member: Maja Hrabak Paar (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Unatoč smanjenju ukupnog broja pušača u svijetu i napretku u liječenju karcinoma pluća, on i dalje ostaje najčešći uzrok smrti među svim novotvorinama. Većina karcinoma pluća i dalje se otkriva u poodmaklim stadijima, što najčešće završava fatalno. Zadnjih 20-ak godina, istraživanja na temu ranog otkrivanja karcinoma pluća pokazala su značajan napredak. Stopa incidencije karcinoma pluća u Hrvatskoj iznosi 76,2/100.000 osoba, a u 2021. godini je od karcinoma pluća umrlo ukupno 2814 osoba. Najvažniji čimbenik koji uzrokuje karcinom pluća je pušenje. Od kraja 90-ih godina 20. stoljeća za rano otkrivanje karcinoma pluća sve više se koristi low dose computed tomography (LDCT), koji omogućuje snimanje s niskim dozama zračenja. Kvaliteta slika koje nastaju takvim protokolom snimanja dovoljna je kako bi se na njima mogli prepoznati sumnjivi plućni noduli. Kako ne bi došlo do nepotrebne pretjerane dijagnostike, razvijaju se algoritmi prema kojima se ti noduli klasificiraju. Provedeno je više istraživanja diljem Europe i Sjedinjenih Američkih Država. Dva najveća od njih su NLST i NELSON. Rezultati tih istraživanja pokazuju značajnu razliku u ukupnom broju dijagnosticiranih karcinoma u istraživanoj skupini u odnosu na kontrolnu skupinu. Karcinomi dijagnosticirani u istraživanoj skupini češće su u prvom stadiju u odnosu na kontrolnu skupinu. Dugogodišnje praćenje sudionika obje studije pokazalo je i smanjenje ukupnog mortaliteta kod osoba koje su se podvrgnule probiru LDCT-om, što je i krajnji cilj istraživanja. Europska komisija ulaže značajne napore u pripremu smjernica i organizaciju probira koji bi se provodio u svim zemljama Europske Unije. Način na koji je organizirana Europska Unija, gdje svaka država donosi svoje zakone otežava sam proces, no za vjerovati je da će se proces probira proširiti diljem Europe. Hrvatska je napravila prve korake te krenula s provođenjem programa 2020. godine. Smjernice se kontinuirano revidiraju kako bi dobiveni podatci bili što vjerodostojniji te ne bi bilo odstupanja zbog grešaka tijekom istraživanja.

Abstract (english)

Despite the overall reduction in the number of smokers worldwide and the advancements in lung cancer treatment, it still remains the most common cause of death among all types of cancer. The majority of lung cancers are still diagnosed at advanced stages, often leading to a fatal outcome. Over the past 20 years, research on early detection of lung cancer has shown significant progress. The incidence rate of lung cancer in Croatia is 76.2 per 100,000 individuals, and in 2021, a total of 2,814 people died from lung cancer. The most important factor causing lung cancer is smoking. Since the late 1990s, low-dose computed tomography (LDCT) has been increasingly used for lung cancer screening, enabling imaging with low radiation doses. The image quality obtained through this imaging protocol is sufficient to detect suspicious nodules. In order to avoid unnecessary overtreatment, algorithms are being developed to classify these nodules. Several studies have been conducted across Europe and the United States, with the two largest ones being NLST and NELSON. The results of these studies demonstrate a significant difference in the overall number of diagnosed cancers in the screening group compared to the control group. Cancers diagnosed in the screening group are more often in the early stage compared to the control group. Long-term follow-up of participants in both studies has also shown a reduction in overall mortality among those who underwent LDCT screening, which is the ultimate goal of the research. The European Commission is making significant efforts to prepare guidelines and organize screening programs to be implemented in all European Union countries. The organizational structure of the European Union, where each country has its own laws, poses challenges to the process, but it is believed that the screening process will be initiated in the near future in all European countries. Croatia has taken the first steps and started implementing the program in 2020. The guidelines are continuously revised to ensure the obtained data is reliable and to minimize deviations due to research errors.

• Keywords: probir; LDCT; mortalitet; karcinom pluća
• Keywords (english): screening; LDCT; mortality; lung cancer
• Language: croatian
• URN:NBN: urn:nbn:hr:105:326308
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-25 09:50:50