[China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2025 Version)].

内容摘要

Lung cancer remains the leading cause of cancer-related deaths in China. Optimizing lung cancer screening strategies to improve screening efficiency and mitigate associated harms has become a key research focus and priority in current clinical practice. The purpose of this paper is to revise the China national lung cancer screening guideline with low-dose computed tomography (LDCT) (2023 version). The revision work for the 2025 version of this guideline was jointly undertaken by experts from the Chinese Expert Group on Early Diagnosis and Treatment of Lung Cancer and experts from the China Lung Oncology Group. Drawing on recent advances in LDCT lung cancer screening at home and abroad, combined with the epidemiological characteristics of lung cancer in China, the expert panel revised the guideline with the following key updates: (1) In the selection criteria of high-risk population, the exposure duration to occupational lung carcinogens is clearly specified; additionally, if an individual's physical condition cannot tolerate potential lung cancer resection surgery or the individual suffers from a life-threatening disease during annual screening, discontinuation of LDCT screening is recommended. (2) The method for measuring nodule size is updated, with mean diameter adopted as the metric for assessing nodule size. (3) In nodule management, the positive threshold for the mean diameter of solid nodules or the solid components of part-solid nodules in baseline screening is raised to 6 mm, and the follow-up interval for positive solid or part-solid nodules is adjusted from 6 months to 3-6 months. (4) It is recommended that informed consent and shared decision-making be integrated throughout the entire process, including high-risk group identification, screening interval determination, and nodule management. This revision further clarifies and optimizes the selection of high-risk groups and the management of screen-detected nodules. Based on a comprehensive balance between the benefits and potential harms of lung cancer screening, it emphasizes the critical importance of informed consent and shared decision-making. This revised guideline will be more aligned with China's national conditions and enhance the standardization and applicability of LDCT-based lung cancer screening across the country.
. 【中文题目：中国肺癌低剂量CT筛查指南（2025年版）】 【中文摘要：肺癌是导致中国癌症死亡的首要原因。通过优化肺癌筛查策略，提高筛查效率，减少相关危害已成为当前肺癌筛查的研究热点和方向。本文的目的是对2023年中国肺癌低剂量计算机断层扫描（low-dose computed tomography, LDCT）筛查指南进行修订。由国家卫健委指定的中国肺癌早诊早治专家组专家及部分中国西部肺癌研究协作中心专家，共同参与了2025年版中国肺癌LDCT筛查指南的修订工作。专家组根据近年来国内外LDCT肺癌筛 查进展，结合我国肺癌流行病学特征，共同修订了本肺癌筛查指南。本指南对以下内容进行了修订：（1）高危人 群定义中明确了职业暴露年限，另外，如果在年度筛查中发现受检者身体状况无法耐受可能的肺癌切除手术，或罹患其他严重威胁生命的疾病，则建议停止LDCT筛查；（2）更新了结节大小的测量方法，将平均直径作为结节大小的衡量指标；（3）结节管理中，将基线筛查中实性结节或部分实性结节实性成分的平均直径阳性阈值提高至6 mm，并将实性结节或部分实性的阳性结节复查时间由6个月调整为3-6个月；（4）建议将知情同意和共同决策贯穿于高危人群选择、筛查间隔和结节管理环节。本次修订进一步明确和优化了高危人群选择及结节管理，并在对肺癌筛查获益和危害充分权衡基础上，强调了知情同意和共同决策的重要性。本次修订将使得LDCT筛查指南更适应我国国情，并提升了我国肺癌筛查的规范性与适用性。
】 【中文关键词：肺肿瘤；筛查；低剂量计算机断层扫描；指南；中国】.