Summary of findings for the main comparison. Lung cancer screening with chest radiography +/‐ sputum cytology versus less intense screening for lung cancer.
| L ung cancer screening with chest radiography +/‐ sputum cytology versus less intense screening for lung cancer | ||||||
| Patient or population: Patients with lung cancer Settings: Intervention: Lung cancer screening with chest radiography +/‐ sputum cytology versus less intense screening | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Lung cancer screening with chest radiography +/‐ sputum cytology versus less intense screening | |||||
| Lung cancer mortality ‐ More frequent chest x‐ray screening versus less frequent screening | 7 per 1000 | 8 per 1000 (7 to 9) | RR 1.11 (0.95 to 1.31) | 81303 (4 studies) | ⊕⊕⊕⊝ moderate1 | |
| Lung cancer mortality ‐ Annual chest x‐ray plus 4‐monthly cytology versus annual x‐ray alone | 29 per 1000 | 25 per 1000 (21 to 29) | RR 0.88 (0.74 to 1.03) | 20427 (2 studies) | ⊕⊕⊕⊕ high | |
| All‐cause mortality ‐ More frequent chest x‐ray screening versus less frequent screening | 83 per 1000 | 84 per 1000 (78 to 90) | RR 1.01 (0.94 to 1.08) | 170149 (4 studies) | ⊕⊕⊝⊝ low2,3 | |
| All‐cause mortality ‐ Annual chest x‐ray plus 4‐monthly cytology versus annual x‐ray alone | 97 per 1000 | 100 per 1000 (88 to 111) | RR 1.03 (0.91 to 1.15) | 10040 (1 study) | ⊕⊕⊕⊕ high | |
| Lung cancer 5‐year survival ‐ More frequent chest x‐ray screening versus less frequent screening | 902 per 1000 | 820 per 1000 (784 to 857) | RR 0.91 (0.84 to 0.99) | 1775 (4 studies) | ⊕⊕⊝⊝ low4,5 | |
| Lung cancer 5‐year survival ‐ Annual chest x‐ray plus 4‐monthly cytology versus annual x‐ray alone | 700 per 1000 | 581 per 1000 (525 to 644) | RR 0.83 (0.75 to 0.92) | 837 (1 study) | ⊕⊕⊕⊝ moderate6 | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 No trials had evidence of adequate allocation concealment and only half had adequate description of drop‐outs. 2 Only half of the trials had clearly reported randomisation and there was no evidence of allocation concealment; only half of the studies had descriptions of drop‐outs. 3 I² = 56% ‐ considerable heterogeneity. 4 No evidence of allocation concealment and only one study had clear evidence of blinding. 5 I² = 68% ‐ substantial heterogeneity. 6 Single study with unclear allocation concealment and unclear risk of bias from drop‐outs.