Bradley, S, Abraham, S, Callister, M et al. (5 more authors) (2019) Sensitivity of chest x-ray for detecting lung cancer in people presenting with symptoms: systematic review. British Journal of General Practice. ISSN 0960-1643
Abstract
Background
Despite increasing use of computed tomography (CT), chest X-ray remains the first-line investigation for suspected lung cancer in primary care in the UK. No systematic review evidence exists as to the sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms.
Aim
To estimate the sensitivity of chest X-ray for detecting lung cancer in symptomatic people.
Design and setting
A systematic review was conducted to determine the sensitivity of chest X-ray for the detection of lung cancer.
Method
Databases including MEDLINE, EMBASE, and the Cochrane Library were searched; a grey literature search was also performed.
Results
A total of 21 studies met the eligibility criteria. Almost all were of poor quality. Only one study had the diagnostic accuracy of chest X-ray as its primary objective. Most articles were case studies with a high risk of bias. Several were drawn from non-representative groups, for example, specific presentations, histological subtypes, or comorbidities. Only three studies had a low risk of bias. Two primary care studies reported sensitivities of 76.8% (95% confidence interval [CI] = 64.5 to 84.2%) and 79.3% (95% CI = 67.6 to 91.0%). One secondary care study reported a sensitivity of 79.7% (95% CI = 72.7 to 86.8%).
Conclusion Though there is a paucity of evidence, the highest-quality studies suggest that the sensitivity of chest X-ray for symptomatic lung cancer is only 77% to 80%. GPs should consider if further investigation is necessary in high-risk patients who have had a negative chest X-ray.
Metadata
Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 British Journal of General Practice. This is an author produced version of a paper published in the British Journal of General Practice. Uploaded in accordance with the publisher's self-archiving policy. | ||||||||
Keywords: | diagnostic imaging; early diagnosis; lung cancer; primary care; X-rays | ||||||||
Dates: |
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Institution: | The University of Leeds | ||||||||
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) |
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Funding Information: |
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Depositing User: | Symplectic Publications | ||||||||
Date Deposited: | 21 May 2019 10:57 | ||||||||
Last Modified: | 19 Nov 2019 14:40 | ||||||||
Status: | Published online | ||||||||
Publisher: | Royal College of General Practitioners | ||||||||
Identification Number: | https://doi.org/10.3399/bjgp19X706853 |
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Filename: CXRSensitivitySRFinalUnmarked.pdf
