The National Comprehensive Cancer Network (NCCN) updates the "NCCN clinical practice guidelines in oncology: Lung cancer screening" annually, and the second edition of 2024 was released in October 2023. The 2024 edition of the guidelines builds on the 2023 edition with some updates on description and assessment of risk factors for lung cancer, evaluation and follow-up of lung nodules found during initial and subsequent screening, and low-dose CT screening protocols and imaging modalities. In this article, we will introduce the above updates and provide reference for lung cancer screening in China by combining the relevant guidelines and consensus in China.
The 2020 ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease not only updates aortic valve stenosis, mitral regurgitation, prosthetic valves, infective endocarditis and antithrombotic treatment on the basis of the 2017 guidelines update for valvular heart disease, but also involves aortic valve regurgitation, bicuspid aortic valve, mitral stenosis, tricuspid regurgitation, combined valve disease, pregnancy with valvular disease, valve disease complicated with coronary heart disease, valve disease complicated with non-cardiac surgery and the prospect of comprehensive management of valve disease. It covers a wide range of contents, which are introduced in detail and comprehensively. This paper interprets some highlights and core issues, including the top 10 take-home messages, the severity of valvular heart disease, and the updates in the management of aortic valve stenosis, aortic valve regurgitation, bicuspid aortic valve, mitral stenosis and mitral regurgitation.
Radiation proctopathy, which can be categorized as acute and chronic, is defined as the radiation damage to the rectum caused by radiation therapy in patients with pelvic malignancies. Chronic radiation proctopathy can cause complications such as rectal bleeding, which severely affects patients’ quality of life. At present, endoscopic therapy has become the primary method for diagnosis and treatment of bleeding from chronic radiation proctopathy. In October 2019, the American Society for Gastrointestinal Endoscopy (ASGE) published "ASGE guideline on the role of endoscopy for bleeding from chronic radiation". The guideline described the effectiveness and safety of different endoscopic therapies such as argon plasma coagulation, bipolar electrocoagulation, heater probe, radiofrequency ablation, cryoablation, etc. in the treatment of bleeding from chronic radiation. This paper interprets it to provide references for clinicians in the treatment of bleeding from chronic radiation.
Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2022 edition) has been published this year. The 2022 edition has been updated in the aspects of lung cancer screening, pathology, standards of thoracic surgery, treatment of metastatic lung cancer. In this study, we tried to introduce those updated aspects in the guideline of 2022 edition.
Respiratory oscillometry is a lung function test that measures the mechanical properties of respiratory system by the forced oscillation technique. Oscillometry can be used in those who cannot perform traditional lung function tests, including young children. It is also an important tool to assess small airways function in clinical and research fields. In 2020, the European Respiratory Society published a new technical standard for respiratory oscillometry, which offered updated technical recommendations on the hardware, software, testing protocols and quality control of oscillometry measurements. This paper interpreted the new technical standard, for providing technical suggestions regarding oscillometry measurements in clinical and research settings, and as a reference for developing technical statements and recommendations for oscillometry in China.
The Technical Specifications for Evaluation of Age-friendly Medical Institutions is a set of evaluation standard for admittance of age-friendly medical institutions. The standard was prepared by Beijing Geriatric Hospital, organized by Beijing Municipal Health Commission and issued by Beijing Municipal Bureau of Market Supervision and Administration in 2021. The standard evaluates the construction of age-friendly medical institutions in four profiles, involving age-friendly culture, age-friendly management, age-friendly service, and age-friendly environment, and standardizes the specific links in the medical institutions evaluation and acceptance, displaying important guiding value for construction activities of national age-friendly medical institutions.
Objective To analyze the status of applying diagnostic test in imaging scientific study internationally and domestically, and to compare the application of the image diagnostic studies of our country with that of abroad. Method We hand-searched the diagnosis tests published in the "Chinese Journal of Radiology", the most influential in China, and in "Radiology’’, the most influential abroad, from 1998 to 1999 respectively. Then we evaluated each of the diagnosis tests according to the international standards. Results We searched 408 original articles in "Chinese Journal of Radiology" in which the diagnostic test articles were 12%, and 796 original articles in "Radiology" with the diagnostic test articles 23% from 1998 to 1999 respectively. In these diagnosis tests, by comparing the "Chinese journal of radiology" with the "Radiology", it was found that 19% applied blind comparison with Gold Standard, 28% calculated sensitivity, specificity and accuracy, 9% both calculated negative predictive value and positive predictive value and none calculated likelihood ratios in the former versus 64%, 57%, 33% and 26% and 3% respectivdy in the latter. Conclusions Compared with the international level, both the quality and the quantity of the diagnosis tests applied in the specialty of imaging scientific study in China are much lower and far from meeting the clinical requirement. Improving the methods of scientific study and carrying on more diagnosis tests with high qualities are of important significance in improving the diagnostic level of imaging.
In recent years, with the clinical application of minimally invasive surgical techniques and comprehensive preoperative treatment, the survival rate of locally advanced esophageal cancer has significantly improved. However, the treatment of metastatic esophagogastric cancer still relies mainly on systemic therapy, and immunotherapy combined with chemotherapy has become a first-line treatment option, prolonging the survival of patients with metastatic esophageal cancer. Oligometastatic esophageal cancer is expected to bring survival benefits through systemic therapy combined with local treatment. The 2024 European clinical practice guidelines for oligometastatic esophagogastric cancer have been officially released, which standardize the definition, diagnosis, and treatment of oligometastatic esophageal cancer for further prospective studies. The authors interpret this guideline, especially by reviewing the clinical evidence of oligometastatic esophageal squamous cell carcinoma, to provide reference for the diagnosis and treatment of oligometastatic esophageal cancer in China.
ObjectiveTo summarize the burden and epidemiological trends of global breast cancer and China’s breast cancer according to the 2018, 2020 and 2022 versions of the global cancer statistics report jointly prepared by the International Cancer Research Institute of the World Health Organization and the American Cancer Society. MethodThe data of global and Chinese breast cancer in the 2018, 2020, 2022 edition of the Global Cancer Statistical Report were analyzed. ResultsIn 2022, the global new breast cancer was estimated to be about 2.309 million, ranking the second. The crude incidence rate of breast cancer was 54.1 per 100 000, and the age standardized incidence rate (ASIR) was 46.8 per 100 000. In 2022, the global breast cancer death would be about 666 000, ranking the fourth, with the crude mortality rate of 11.3 per 100 000, age standardized mortality rate (ASMR) was 12.6 per 100 000. The incidence rate and mortality rate of breast cancer vary greatly between regions/countries, and were related to the human development index; the crude incidence rate was high in economically developed regions, and the crude mortality rate was relatively increasing, but the ASMR was low. In economically underdeveloped areas, the crude incidence rate was relatively low, and the crude mortality rate was relatively decreasing, but ASMR was high. In 2022, the number of breast cancer patients in China would be 357 000, ranking the fourth, with a crude incidence rate of 51.7 per 100 000 and an ASIR of 33.0 per 100 000. In 2022, there would be about 75 000 deaths from breast cancer in China, ranking the seventh, with a crude mortality rate of 10.9 per 100 000 and an ASMR of 6.1 per 100 000. From 2018 to 2022, the incidence rate and mortality rate of breast cancer in China show a downward trend. ConclusionsBoth the world and China are facing a severe burden of breast cancer, and breast cancer prevention and treatment has a long way to go.
Primary malignant bone tumors are extremely rare. Osteosarcoma, chondrosarcoma, Ewing’s sarcoma, and myeloma are the most common malignancy in bone. Osteosarcoma and Ewing’s sarcoma are common in children and adolescents, and the tumors are high lethality due to the high rate of pulmonary metastasis. While chondrosarcoma, myeloma, and chordoma are more common in middle aged and elderly people. Japanese Orthopaedic Association (JOA) published the secondary clinical practice guideline on the management of primary malignant bone tumors. We put an emphasis on explanation some important issue of this guideline for help Chinese musculoskeletal tumor professionals in clinical practice.