Friend's uncle rode a battery car a few days ago accidentally fell, ankle fracture ready for hospitalization, outpatient routine chest CT screening new crown, this check turned out to be a big problem, the right lung 4cm soft tissue shadow, highly suspect malignant tumor, and mediastinal lymphadenopathy, consider metastasis. This result makes it difficult for their family to accept, usually there are no symptoms, how to check is the advanced stage of lung cancer.
Rome was not built in a day, lung lumps did not grow in a day, many people did not enter the hospital for several years, never thought about physical examinations, and even the free physical examinations of the unit never participated. After I saw the film of this friend's relative, I knew that he himself was a high-risk group of lung cancer, with obvious emphysema and pulmonary vesicles in the lungs, which was obviously the result of long-term smoking. However, in recent years, he has not taken the initiative to go to the hospital for physical examination.
Unlike other diseases, cancer often sprouts without any symptoms, so don't expect to have some signal to remind yourself that you might be sick. When symptoms appear, cancer often means that it is not early. The same is true for lung cancer, there are no nerves in the lungs, there is no pain when the tumor appears, and once the pain is felt, it is possible that the tumor is already large and invades the pleura or ribs. Therefore, active screening and physical examination is the right way, "early diagnosis, early treatment" is the most important way to improve the survival rate of lung cancer patients and reduce the mortality rate of patients, and it is also the most effective method. Lung cancer screening is simpler than other tumor screening, that is, doing low-dose spiral CT of the chest, which is convenient and fast.
Who needs to be screened for lung cancer?
In March 2021, the Guidelines for Screening and Early Diagnosis and Early Treatment of Lung Cancer in China (2021, Beijing) (hereinafter referred to as the "Guidelines") were released, which clearly and meticulously elaborated on the high risk factors and screening recommendations for lung cancer in China. The Guidelines clearly state that risk factors for lung cancer include:
1. Smoking, second-hand smoke exposure;
2. History of chronic obstructive pulmonary disease (COPD);
3. Family history of lung cancer in first degree relative (FDR);
4. Asbestos, radon, beryllium, chromium, cadmium, nickel, silicon, soot and soot are exposed for at least 1 year.
While clarifying the risk factors for lung cancer, the Guidelines also describe the protective factors for lung cancer. The Guidelines emphasize that sensible physical activity and fresh vegetable and fruit intake are protective factors for lung cancer. Studies have shown that exercise reduces the risk of lung cancer by 25.0%, and people with high fruit and vegetable intake have a 14.0% lower risk of lung cancer than those with low intake.
In terms of age requirements, the guidelines recommend that people over the age of 50 who have the above risk factors should start lung cancer screening, do low-dose spiral CT of the chest once a year, and do not recommend using chest radiograph (DR) for screening.
In terms of smoking requirements, the number of years of smoking packages is ≥ 30 packs of years (the number of packs smoked per day × the number of years of smoking), and the number of people who have quit smoking for < 15 years. Exposure to secondhand smoke is 20 years of living or working with smokers ≥.
FDR First-degree relatives are parents, children and siblings.
In fact, in the "China Expert Consensus on Lung Cancer Screening and Management (2019)", the age is more stringent, and it is recommended that people over the age of 40 start lung cancer screening. The amount of smoking is more demanding, and the amount of smoking is 20 packs per year, which is what we used to call the smoking index of more than 400, which should be actively screened.
In addition, genetic factors also play an important role in the occurrence and development of lung cancer. Therefore, not only first-degree relatives have a family history of lung cancer, but people with a family history of malignant tumors meet other conditions and should also have an active physical examination.