肾癌风险分层筛查.pdf

1、Risk Stratified Screening for Kidney CancerGrant D StewartProfessor of Surgical Oncology,University of CambridgeHonorary Consultant Urologist,Addenbrookes Hospital,Cambridge,UKDisclosuresNICENational Kidney Cancer AuditAstraZenecaEvinovaBJU InternationalBMSEducational grants/fundingXConsultancyXTrav

2、el expensesXHonoraria/Speakers feesXEmploymentXXXWhy?How can we improve survival from kidney cancer?My bias1.Treat high risk localised disease better with drugs around time of surgery2.Detect disease earlyLong story shortYKST:NCT05005195Stewart G et al.European Urology.2024 DOI:10.1016/j.eururo.2024

3、.08.029Context and aimContext and aim Kidney cancer estimated prevalence of only 0.17%makes stand-alone programme unlikely Targeted lung cancer screening provides one such opportunity for combined screening approaches Smoking is a strong risk factor for kidney cancer(RR=1.6)vs obesity(RR=1.8)vs HT(R

4、R=1.7)vs FHx 1st degree(RR=4.3)YKST aimed to assess the feasibility of adding abdominal non-contrast CT to screen for kidney cancer and other abdominal pathology to the chest CT offered within lung cancer screeningRossi SH et al.The Surgeon.2023.doi.org/10.1016/j.surge.2023.10.010Harrison H et al.Eu

5、r Urol Oncol.2023.doi.org/10.1016/j.euo.2023.02.012Study design and recruitmentStudy design and recruitment Embedded with Yorkshire Lung Screening Trial(YLST)55-80 year-old ever-smokers at high risk of lung cancer attending second round of lung cancer screening between May 2021-October 2022Stewart G

6、 et al.European Urology.2024 DOI:10.1016/j.eururo.2024.08.029Primary OutcomesPrimary Outcomes1.The proportion of individuals attending the T2 round of YLST who take up the offer of an abdominal CT scan 2.The acceptability to participants of combined lung and RCC screening by non-contrast CT scanning