翻译整理：凤凰重生
什么是CT肺癌筛查？
CT Lung Screening
肺部CT筛查是使用低剂量X射线筛选肺的癌症，可以在短短30秒内无创、无痛完成整个过程。CT肺筛查是使用螺线X线扫描技术扫描整个胸部，使放射科医生能够看到不同成次的肺部断层图片。这个过程在一个多层螺旋计算机断层扫描（CT）扫描仪中进行，可以检查出比标准X光胸片更小的结节或肿瘤。肿瘤或结节是在肺上生长的细胞群，它可以是良性的（非癌性）或恶性的（癌性的）。通过CT肺筛查，可以发现早期恶性肿瘤，从而可以定位及早期治疗，增加存活率。
CT lung screening is a noninvasive, painless procedure that uses low-dose x-rays to screen the lungs for cancer in just 30 seconds. A CT lung screening allows the radiologist to look at different levels, or slices, of the lungs using a rotating X-ray beam. It is performed on a multislice spiral computed tomography (CT) scanner and can detect smaller nodules or cancer than standard chest X-rays. A tumor or nodule is a mass of cells that grows on the lungs. It can be benign (noncancerous) or malignant (cancerous). By detecting malignant tumors in an early stage with CT lung screening, the cancer cells can be treated at a time when the cancer still has promising survival rates and is localized to the lungs.
这项检查无需提前做准备。在检查中，患者平躺在检查床上，头朝向机器方向，双手举过头顶；开始扫描时，受检者只需要简单的闭住气；很短的时间里受扫描区域即可完全通过扫描野，受检者可以看到扫描仪前后是开放的。扫描技师在不到五分钟的扫描过程中可以听到和看到受检者的具体情况。
There are no preparations required for this study. During the exam, patients lie on their backs on an exam table with arms above the head. They must hold their breath briefly as the pictures are being taken. For a short period of time, the body may be covered by a scanner, but the scanner is open at the back and front so that the patient can see out. The technologist is always able to see and hear the patient during the five-minute procedure.
为什么肺癌筛查很重要？
肺癌是美国癌症相关死亡的首要原因。这种疾病每年导致的死亡病例，比乳腺癌，前列腺癌和结肠直肠癌加起来还要多。在美国，发展侵袭性肺癌的终身风险的比例是男性为1/17，女性为1/18。
Lung cancer is the number one cause of cancer-related deaths in the United States. This disease is responsible for more deaths annually than breast, prostate, and colorectal cancers combined. In the United States, the lifetime risk of developing invasive lung cancer is 1 in 17 for men and 1 in 18 for women.
据估计，如果在早期阶段检测到的肺癌的80％以上，可以治愈。不幸的是，只有15％的肺癌在此阶段被诊断，使得对于肺癌的20％的所有阶段的五年存活率。使肺癌所有阶段的五年生存率仅仅为20％。在早期阶段能够检查出肺癌，而且肺癌没有转移也是至关重要的。当肿瘤生长到3cm或更多时，人的生存机会减少很多。 如果癌症扩散到肺外部的身体其他区域，存活率仅为5％，而如果早期检测到癌症，则为70％。CT肺筛查能够检测到小至2或3 mm的肺结节。通过定性恶性肿瘤，当它们仍然很小时，可以在疾病传播到身体的其他区域之前通过手术除去。
It is estimated that over 80 percent of lung cancers could be cured if detected at an early stage. Unfortunately, only 15 percent of lung cancers are caught at this stage, making the five-year survival rate for all stages of lung cancer 20%. Catching lung cancer in an early stage while it is still localized to the lung is essential. A person's chance of survival decreases when the tumor grows to be 3 cm or more. If the cancer spreads to areas of the body outside the lungs, the survival rate is only 5 percent, compared with 70 percent if the cancer is detected early. CT lung screening is capable of detecting lung nodules as small as 2 or 3 mm. By catching malignant tumors when they are still small, they can be surgically removed before disease spreads to other areas of the body.
什么人应该进行肺部筛选？
美国预防服务工作组，国家综合癌症网络，美国胸科医生学院，美国临床肿瘤学会，美国癌症协会，美国胸科学会和美国放射学院建议对55至77岁之间具有以下任何风险因素的个人进行肺筛查：
The U.S. Preventive Services Task Force, National Comprehensive Cancer Network, American College of Chest Physicians, American Society of Clinical Oncology, American Cancer Society, American Thoracic Society, and the American College of Radiology recommend lung screening for individuals between 55 and 77 who have any of the following risk factors:
1、·肺癌病史
2、吸烟积累指数30包，或更多的吸烟史（每天一包香烟30年，每天两包香烟15年等）
3、·过去的吸烟积累指数30包（少于15年前）
4、·接触其他致癌物质（如石棉和氡）
对于仍然处于高风险的患者，建议每年一次进行随访筛查。重要的是，患者应该意识到，虽然扫描结果是阴性（无结节或癌症），
并不意味着肺癌不会在未来发生，因为它们依旧保持着在该疾病的高风险。
· History of lung cancer
· 30 pack-year or more smoking history (one pack of cigarettes per day for 30 years, two packs of cigarettes per day for 15 years, etc.)
· Past history of 30 pack-year smoking (less than 15 years ago)
· Exposure to other cancer-causing agents (eg, asbestos and radon)
Follow-up screening is recommended every once a year for patients who remain at high risk. It is important for patients to be aware that having a negative scan (no nodules or cancer) does not mean that lung cancer will not develop in the future if they remain at high risk for the disease.
妇女和肺癌
1987年，肺癌超过乳腺癌是妇女癌症死亡的主要原因。虽然男性肺癌死亡人数已经稳定，但是妇女肺癌死亡人数继续增加。美国肺协会的Lung Force极力寻求肺健康，团结妇女，一起对抗肺癌。
In 1987, lung cancer surpassed breast cancer as the leading cause of cancer deaths in women. Although the number of lung cancer deaths in men has plateaued, the number of lung cancer deaths among women continues to increase. The American Lung Association's Lung Force seeks to unite women to stand together against lung cancer and for lung health.
肺筛查的准确性如何？
最近的研究显示，CT肺筛查在检测肺癌方面比标准肺筛选方法（即，胸部X射线，痰细胞学）更灵敏。与标准胸部X线不同，CT肺筛查采用肺的横截面图像。 这允许放射科医生从上到下看肺。 胸部X射线只显示从前面和侧面的肺的视图。 使用3D成像，CT肺筛查可以测量肿瘤在所有方向的生长，而标准X射线只能在其最宽点测量肿瘤，从而阻止了放射科医师跟踪肿瘤体积的变化。
Recent studies show that CT lung screening is more sensitive than standard lung screening methods (ie, chest X-ray, sputum cytology) in detecting lung cancer. Unlike standard chest X-rays, CT lung screening takes cross-sectional images of the lungs. This allows the radiologist to see the lungs from top to bottom. Chest X-rays only show views of the lungs from the front and sides. With 3D imaging, CT lung screening can measure the growth of tumors in all directions whereas standard x-rays can only measure tumors at their widest point, preventing the radiologist from tracking changes in the volume of the tumor.
该过程是否涉及辐射？
肺部CT筛查确实涉及辐射暴露在X射线的形式，但准确的诊断远远大于风险的好处。来自该程序的有效辐射剂量为约1至1.5mSv，其小于六个月中从背景辐射接收的普通人的有效辐射剂量。
CT lung screening does involve exposure to radiation in the form of X-rays, but the benefit of an accurate diagnosis far outweighs the risk. The effective radiation dose from this procedure is about 1 to 1.5 mSv, which is less than the average person receives from background radiation in six months.
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