Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study
Background Lung cancer (LC) screening improves LC survival; the best screening method in terms of improving survival is low-dose CT (LDCT), outpacing chest X-ray and sputum cytology.Methods A consensus of experts in Argentina was carried out to review the literature and generate recommendations for...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-02-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/2/e068271.full |
| _version_ | 1797903916592005120 |
|---|---|
| author | Claudio Martin Gonzalo Recondo Javier Roberti Ezequiel García Elorrio Mònica Castro Diego Kaen Iris Boyeras Mariana Seijo Verónica Suárez José Luis Morero Ana Karina Patané Sebastián Lamot Ricardo Re Artemio García Patricia Vujacich Alejandro Videla Alfonso Fernández-Pazos Gustavo Lyons Hugo Paladini Sergio Benítez Sebastián Defranchi Lisandro Paganini Silvia Quadrelli Sebastián Rossini Edgardo Sobrino |
| author_facet | Claudio Martin Gonzalo Recondo Javier Roberti Ezequiel García Elorrio Mònica Castro Diego Kaen Iris Boyeras Mariana Seijo Verónica Suárez José Luis Morero Ana Karina Patané Sebastián Lamot Ricardo Re Artemio García Patricia Vujacich Alejandro Videla Alfonso Fernández-Pazos Gustavo Lyons Hugo Paladini Sergio Benítez Sebastián Defranchi Lisandro Paganini Silvia Quadrelli Sebastián Rossini Edgardo Sobrino |
| author_sort | Claudio Martin |
| collection | DOAJ |
| description | Background Lung cancer (LC) screening improves LC survival; the best screening method in terms of improving survival is low-dose CT (LDCT), outpacing chest X-ray and sputum cytology.Methods A consensus of experts in Argentina was carried out to review the literature and generate recommendations for LC screening programmes. A mixed-method study was used with three phases: (1) review of the literature; (2) modified Delphi consensus panel; and (3) development of the recommendations. The Evidence to Decision (EtD) framework was used to generate 13 evaluation criteria. Nineteen experts participated in four voting rounds. Consensus among participants was defined using the RAND/UCLA method.Results A total of 16 recommendations scored ≥7 points with no disagreement on any criteria. Screening for LC should be performed with LDCT annually in the population at high-risk, aged between 55 and 74 years, regardless of sex, without comorbidities with a risk of death higher than the risk of death from LC, smoking ≥30 pack-years or former smokers who quit smoking within 15 years. Screening will be considered positive when finding a solid nodule ≥6 mm in diameter (or ≥113 mm3) on baseline LDCT and 4 mm in diameter if a new nodule is identified on annual screening. A smoking cessation programme should be offered, and cardiovascular risk assessment should be performed. Institutions should have a multidisciplinary committee, have protocols for the management of symptomatic patients not included in the programme and distribute educational material.Conclusion The recommendations provide a basis for minimum requirements from which local institutions can develop their own protocols adapted to their needs and resources. |
| first_indexed | 2024-04-10T09:40:26Z |
| format | Article |
| id | doaj.art-0ec45a0822b1451aa2b5512c3ad097d6 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-10T09:40:26Z |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-0ec45a0822b1451aa2b5512c3ad097d62023-02-17T10:00:11ZengBMJ Publishing GroupBMJ Open2044-60552023-02-0113210.1136/bmjopen-2022-068271Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi studyClaudio Martin0Gonzalo Recondo1Javier Roberti2Ezequiel García Elorrio3Mònica Castro4Diego Kaen5Iris Boyeras6Mariana Seijo7Verónica Suárez8José Luis Morero9Ana Karina Patané10Sebastián Lamot11Ricardo Re12Artemio García13Patricia Vujacich14Alejandro Videla15Alfonso Fernández-Pazos16Gustavo Lyons17Hugo Paladini18Sergio Benítez19Sebastián Defranchi20Lisandro Paganini21Silvia Quadrelli22Sebastián Rossini23Edgardo Sobrino24Medicine (Critical Care), London Health Sciences Centre, London, Ontario, CanadaCenter for Medical Education and Clinical Research Norberto Quirno (CEMIC), Buenos Aires, ArgentinaDepartment of Healthcare Quality and Patient Safety, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, ArgentinaDepartment of Healthcare Quality and Patient Safety, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, ArgentinaAngel Roffo Oncology Institute, Universtiy of Buenos Aires, Buenos Aires, ArgentinaHospital de Clínicas Virgen María de Fátima, National University of La Rioja, La Rioja, ArgentinaAngel Roffo Oncology Institute, Universtiy of Buenos Aires, Buenos Aires, ArgentinaDepartment of Healthcare Quality and Patient Safety, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, ArgentinaPneumonology Service, Clínica Bazterrica, Buenos Aires, ArgentinaAlexander Fleming Institute, Buenos Aires, ArgentinaMunicipal Hospital María Ferrer, Buenos Aires, ArgentinaConciencia Clinic, Neuquén, ArgentinaCenter for Medical Education and Clinical Research Norberto Quirno (CEMIC), Buenos Aires, ArgentinaProf. Posadas National Hospital, El Palomar, Buenos Aires, ArgentinaHospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, ArgentinaAustral University Hospital, Pilar, ArgentinaOSDE, Buenos Aires, ArgentinaBritish Hospital of Buenos Aires, Buenos Aires, Federal District, ArgentinaMedical Images Service MIT Group, Santa Fe, ArgentinaHospital Zonal Juan Ramón Carrillo, San Carlos de Bariloche, Río Negro, ArgentinaFavaloro Foundation University Hospital, Buenos Aires, Federal District, ArgentinaAlexander Fleming Institute, Buenos Aires, ArgentinaBritish Hospital of Buenos Aires, Buenos Aires, Federal District, ArgentinaRadiology Institute of Mar del Plata, Mar del Plata, ArgentinaSanatorio Mater Dei, Buenos Aires, ArgentinaBackground Lung cancer (LC) screening improves LC survival; the best screening method in terms of improving survival is low-dose CT (LDCT), outpacing chest X-ray and sputum cytology.Methods A consensus of experts in Argentina was carried out to review the literature and generate recommendations for LC screening programmes. A mixed-method study was used with three phases: (1) review of the literature; (2) modified Delphi consensus panel; and (3) development of the recommendations. The Evidence to Decision (EtD) framework was used to generate 13 evaluation criteria. Nineteen experts participated in four voting rounds. Consensus among participants was defined using the RAND/UCLA method.Results A total of 16 recommendations scored ≥7 points with no disagreement on any criteria. Screening for LC should be performed with LDCT annually in the population at high-risk, aged between 55 and 74 years, regardless of sex, without comorbidities with a risk of death higher than the risk of death from LC, smoking ≥30 pack-years or former smokers who quit smoking within 15 years. Screening will be considered positive when finding a solid nodule ≥6 mm in diameter (or ≥113 mm3) on baseline LDCT and 4 mm in diameter if a new nodule is identified on annual screening. A smoking cessation programme should be offered, and cardiovascular risk assessment should be performed. Institutions should have a multidisciplinary committee, have protocols for the management of symptomatic patients not included in the programme and distribute educational material.Conclusion The recommendations provide a basis for minimum requirements from which local institutions can develop their own protocols adapted to their needs and resources.https://bmjopen.bmj.com/content/13/2/e068271.full |
| spellingShingle | Claudio Martin Gonzalo Recondo Javier Roberti Ezequiel García Elorrio Mònica Castro Diego Kaen Iris Boyeras Mariana Seijo Verónica Suárez José Luis Morero Ana Karina Patané Sebastián Lamot Ricardo Re Artemio García Patricia Vujacich Alejandro Videla Alfonso Fernández-Pazos Gustavo Lyons Hugo Paladini Sergio Benítez Sebastián Defranchi Lisandro Paganini Silvia Quadrelli Sebastián Rossini Edgardo Sobrino Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study BMJ Open |
| title | Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study |
| title_full | Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study |
| title_fullStr | Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study |
| title_full_unstemmed | Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study |
| title_short | Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study |
| title_sort | argentine consensus recommendations for lung cancer screening programmes a rand ucla modified delphi study |
| url | https://bmjopen.bmj.com/content/13/2/e068271.full |
| work_keys_str_mv | AT claudiomartin argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT gonzalorecondo argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT javierroberti argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT ezequielgarciaelorrio argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT monicacastro argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT diegokaen argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT irisboyeras argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT marianaseijo argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT veronicasuarez argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT joseluismorero argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT anakarinapatane argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT sebastianlamot argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT ricardore argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT artemiogarcia argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT patriciavujacich argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT alejandrovidela argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT alfonsofernandezpazos argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT gustavolyons argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT hugopaladini argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT sergiobenitez argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT sebastiandefranchi argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT lisandropaganini argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT silviaquadrelli argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT sebastianrossini argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy AT edgardosobrino argentineconsensusrecommendationsforlungcancerscreeningprogrammesaranduclamodifieddelphistudy |