MINISTRY OF EDUCATION
AND TRAINING
MINISTRY OF HEALTH
HANOI MEDICAL UNIVERSITY
NGUYEN TIEN DUNG
STUDY ON SCREENING RESULTS TO DETECT LUNG
CANCER IN SUBJECTS OVER 60 YEARS OLD WITH RISK
FACTORS BY USING LOW-DOSE COMPUTED
TOMOGRAPHY
Specialization: Respiratory specialty
Code : 62720144
SUMMARY OF DOCTORAL THESIS IN MEDICINE
HA NOI – 2020
RESEARCH WAS ACCOMPLISHED IN:
HANOI MEDICAL UNIVERSITY
Science Instructors:
1. Prof. Ngo Quy Chau
2. A/Prof. Nguyen Quoc Dung
Reviewer 1:
Reviewer 2:
Reviewer 3:
The thesis will be defended to University Council at Hanoi Medical
University at o’clock 00 on .../.../ 2020
The thesis can be found at:
- National Library.
- Library of Hanoi Medical University.
LIST OF PUBLICATIONS RELATED WITH THESIS
1. Nguyen Tien Dung, Ngo Quy Chau, Nguyen Quoc Dung (2019).
Initial screening results for early detection of lung cancer in
elderly patients with risk factors for low-dose computed
tomography. Vietnam Medical Journal, 474/2019, 112-116.
2. Nguyen Tien Dung, Ngo Quy Chau, Nguyen Quoc Dung (2019).
The results of the observation of nodule changes detected on
screening by low-dose computed tomography through routine
computed tomography. Vietnam Medical Journal, 474/2019, 57-
61.
1
INTRODUCTION OF THESIS
1. Background:
Lung cancer is one of the common cancers. The disease has the
highest incidence and mortality among cancers, most commonly seen in
the elderly especially over 60 years old. The majority of lung cancer is
related to secondhand and passive smoking and has over 80 % lung
cancer is detected at a later stage, only about 15% of cases of lung
cancer are diagnosed with surgery. Therefore, screening methods for
early detection of lung cancer now play an important role in reducing
mortality and prolonging life for patients.
Screening is a method for early diagnosis of cancer in high-risk
subjects. The conventional method of radiography is currently the most
commonly used, but it has many limitations, especially it is difficult to
detect small nodules smaller than 10mm and blurred spots obscured by ribs
and heart shadows. Currently, there are a number of other advanced
screening methods that have been widely used in the world, especially low-
dose computed tomography (LDCT). This is a chest imaging technique
using computed tomography scan, using a lower radiation dose than the
routine computed tomography (radiation dose ranges from 0.6 mSV to 1.4
mSV) for patients of advanced age and smoke heavily or be exposed to
toxic substances for diagnosis and early detection of lung cancer.
There are many studies around the world that have long proven the
effectiveness of LDCT on the ability to detect nodules as well as the
ability to diagnose lung cancer at an early stage, longer survival time
after diagnosis as research. ELCAP from 1993-1998, research of
Henschke 1993-2005, research of Somme 2018 ...
In Vietnam, computed tomography is available in most hospitals.
Moreover, the diagnosis of lung cancer by LDCT combined with
follow-up and histopathological diagnosis has not been applied and
studied in Vietnam. Therefore, we conducted the project: " Study on
screening results to detect lung cancer in subjects over 60 years old
with risk factors by using low-dose computed tomography” with the
following objectives:
1. Evaluation of lung cancer screening results by low-dose computed
tomography in subjects over 60 years old with risk factors
2
2. Research the results of the application of follow-up and diagnosis of
nodules in the lungs of Mayo Clinic hospital-United States after 3-6 months.
2. Urgency of the themes
Lung cancer is an increasing disease, with more than 80% of lung
cancer detected at a later stage, with a short survival time after
diagnosis only about 15% of cases of lung cancer are diagnosed with
surgery. Methods for early diagnosis and early detection have not been
developed in Vietnam, especially for LDCT. The follow up of nodules
has not been studied seriously to have a proper route, both capable of early
diagnosis and not having to follow up many times. Therefore, the
application of advanced diagnostic methods using LDCT and strict follow
up of nodules according to the updated international recommendations is
very necessary in Vietnam.
3. New contributions of the thesis:
This is the first research thesis in Vietnam on the diagnosis of lung
cancer by LDCT. The study has identified results of LDCT, identified
histopathological results after LDCT, after follow-up scans, assessed
the follow-up process after 3-6 months, and oriented physicians about
the probability of cancer in pulmonary nodules
The study contributes to providing clinicians with additional tracking
methods, reasonable time follow up to detect lung cancer in time.
4. The composition of the thesis:
The dissertation consists of 123 pages, of which: Introduction (2
pages), Chapter 1: Overview (38 pages), Chapter 2: Research
Objectives and methodology (17 pages), Chapter 3: Research Results
(29 pages), chapter 4: Discussion (34 pages), conclusion (2 pages),
recommendations (1 page). In the thesis there are (47 tables), 3 charts,
16 figures, 4 diagrams.
The dissertation contains 135 materials, of which 14 are in
Vietnamese, 128 are in English, 3 are in French, the main materials are
in the last 5 years.
CHAPTER 1. OVERVIEW
1.1. Overview of UTP
1.1.1. Definition of UTP
1.1.2. Epidemiology of lung cancer in subjects over 60 years old
1.1.3. Causes and risk factors for lung cancer