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Screening karcinomu plic je preventivn\u00ed vy\u0161et\u0159en\u00ed, kter\u00e9 slou\u017e\u00ed k odhalen\u00ed rakoviny plic v\u00a0ran\u00e9 f\u00e1zi onemocn\u011bn\u00ed. Vy\u0161et\u0159en\u00ed prost\u0159ednictv\u00edm n\u00edzkod\u00e1vkov\u00e9ho\u00a0CT (po\u010d\u00edta\u010dov\u00e1 tomografie) je pro pacienta nen\u00e1ro\u010dn\u00e9 a je pova\u017eov\u00e1no za\u00a0nej\u00fa\u010dinn\u011bj\u0161\u00ed.\u00a0Indikovat pacienta k\u00a0vy\u0161et\u0159en\u00ed CT skenov\u00e1n\u00ed s\u00a0n\u00edzkou d\u00e1vkou z\u00e1\u0159en\u00ed m\u016f\u017ee v\u0161eobecn\u00fd praktick\u00fd l\u00e9ka\u0159 nebo tak\u00e9 p\u0159\u00edmo specialista \u2013 ambulantn\u00ed pneumolog<\/b>. Popula\u010dn\u00ed pilotn\u00ed program \u010dasn\u00e9ho z\u00e1chytu karcinomu plic byl spu\u0161t\u011bn 1. 1. 2022.<\/p>\n
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Rakovina plic m\u016f\u017ee b\u00fdt dlouhou dobu asymptomatick\u00e1, tzn. pacienti nemus\u00ed l\u00e9ta poci\u0165ovat \u017e\u00e1dn\u00e9 projevy onemocn\u011bn\u00ed a\u00a0zdravotn\u00ed obt\u00ed\u017ee. V\u00a0p\u0159\u00edpad\u011b, \u017ee je onemocn\u011bn\u00ed diagnostikov\u00e1no a\u017e na z\u00e1klad\u011b klinick\u00fdch p\u0159\u00edznak\u016f, b\u00fdv\u00e1 zpravidla ji\u017e v\u00a0pozdn\u00edm st\u00e1diu a \u00fa\u010dinnost l\u00e9\u010dby m\u016f\u017ee b\u00fdt omezen\u00e1.<\/p>\n
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Mezi nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010diny vzniku rakoviny plic pat\u0159\u00ed kou\u0159en\u00ed. Pacient je v\u00a0pr\u016fb\u011bhu cel\u00e9ho pilotn\u00edho programu \u010dasn\u00e9ho z\u00e1chytu karcinomu plic edukov\u00e1n o pozitivn\u00edm efektu ukon\u010den\u00ed kou\u0159en\u00ed.\u00a0V\u010dasn\u00e9 zachycen\u00ed karcinomu je kl\u00ed\u010dov\u00e9 \u2013 n\u00e1dor je v\u00a0t\u00e9 dob\u011b je\u0161t\u011b dob\u0159e\u00a0operovateln\u00fd a bez metast\u00e1z do\u00a0okoln\u00edch i vzd\u00e1len\u00fdch tk\u00e1n\u00ed, \u010d\u00edm\u017e se zvy\u0161uje \u0161ance na \u00fasp\u011b\u0161nou l\u00e9\u010dbu a vyl\u00e9\u010den\u00ed.<\/p>\n
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Kdo se m\u016f\u017ee nechat vy\u0161et\u0159it?<\/b><\/p>\n
Vy\u0161et\u0159it se mohou nechat sou\u010dasn\u00ed i b\u00fdval\u00fd ku\u0159\u00e1ci \u010di ku\u0159a\u010dky ve v\u011bku od 55 do 74 let, jejich\u017e ku\u0159\u00e1ck\u00e1 z\u00e1t\u011b\u017e je minim\u00e1ln\u011b 20 bal\u00ed\u010dkorok\u016f \u2013 tzn. 20 vykou\u0159en\u00fdch cigaret denn\u011b po dobu 20 let (nebo ekvivalentn\u00ed po\u010det vykou\u0159en\u00fdch cigaret za del\u0161\u00ed nebo krat\u0161\u00ed obdob\u00ed ne\u017e 20 let).<\/b>\u00a0\u00da\u010dast v\u00a0tomto popula\u010dn\u00edm pilotn\u00edm programu je dobrovoln\u00e1 a zdarma.<\/p>\n
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Kdo mi nap\u00ed\u0161e doporu\u010den\u00ed a kde m\u011b vy\u0161et\u0159\u00ed?<\/b><\/p>\n
Prvotn\u00edm kontaktem by m\u011bl b\u00fdt registruj\u00edc\u00ed praktick\u00fd l\u00e9ka\u0159,\u00a0kter\u00fd m\u00e1 pacienta v dlouhodob\u00e9 a\u00a0pravideln\u00e9 p\u00e9\u010di.\u00a0Praktick\u00fd l\u00e9ka\u0159\u00a0s pacientem probere jeho anamn\u00e9zu, a pokud zjist\u00ed, \u017ee se jedn\u00e1 o rizikovou osobu, kter\u00e1\u00a0<\/b>spl\u0148uje krit\u00e9ria\u00a0<\/b>(v\u011bk a ku\u0159\u00e1ckou historii)\u00a0programu \u010dasn\u00e9ho z\u00e1chytu karcinomu plic, ode\u0161le pacienta k\u00a0dal\u0161\u00edmu vy\u0161et\u0159en\u00ed<\/b>\u00a0k\u00a0l\u00e9ka\u0159i specialistovi \u2013 pneumologovi.<\/b><\/p>\n
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Pneumolog s\u00a0pacientem absolvuje kr\u00e1tk\u00fd pohovor, b\u011bhem kter\u00e9ho si dopln\u00ed pot\u0159ebn\u00e9 informace. N\u00e1sledn\u011b pacienta fyzik\u00e1ln\u011b vy\u0161et\u0159\u00ed (pohledem, pohmatem, poslechem, poklepem), vylou\u010d\u00ed jin\u00e1 z\u00e1va\u017en\u00e1 onemocn\u011bn\u00ed, provede vy\u0161et\u0159en\u00ed plicn\u00edch funkc\u00ed (nap\u0159. spirometrii, pulzn\u00ed oxymetrii), p\u0159\u00edpadn\u011b dopln\u00ed vhodn\u00e1 diagnostick\u00e1 vy\u0161et\u0159en\u00ed a podpo\u0159\u00ed pacienta v\u00a0zanech\u00e1n\u00ed kou\u0159en\u00ed kr\u00e1tkou protiku\u0159\u00e1ckou intervenc\u00ed (eduka\u010dn\u00edm pohovorem).<\/b><\/p>\n
Pneumolog ode\u0161le pacienta k\u00a0LDCT (low dose = n\u00edzkod\u00e1vkov\u00e9 CT) vy\u0161et\u0159en\u00ed<\/b>\u00a0na\u00a0akreditovan\u00e9 radiologick\u00e9 pracovi\u0161t\u011b v\u00a0komplexn\u00edm onkologick\u00e9m centru<\/b>\u00a0(KOC) nebo na akreditovan\u00e9 radiologick\u00e9 pracovi\u0161t\u011b, kter\u00e9 s\u00a0KOC spolupracuje. Toto specializovan\u00e9 pracovi\u0161t\u011b mus\u00ed spl\u0148ovat\u00a0akredita\u010dn\u00ed standardy pro centra za\u0159azen\u00e1 do programu<\/a><\/strong>. LDCT\u00a0skenov\u00e1n\u00ed prov\u00e1d\u00ed odborn\u00fd l\u00e9ka\u0159 \u2013 radiolog, kter\u00fd vyhodnot\u00ed vy\u0161et\u0159en\u00ed a podrobn\u011b pop\u00ed\u0161e n\u00e1lez.<\/p>\n \n V\u00fdsledek vy\u0161et\u0159en\u00ed n\u00edzkod\u00e1vkov\u00fdm CT (LDCT)<\/b><\/p>\n Radiologick\u00e9 pracovi\u0161t\u011b p\u0159ed\u00e1v\u00e1 v\u00fdsledek LDCT vy\u0161et\u0159en\u00ed indikuj\u00edc\u00edmu l\u00e9ka\u0159i \u2013 pneumologovi nebo praktick\u00e9mu l\u00e9ka\u0159i<\/strong>. N\u00e1sledn\u011b l\u00e9ka\u0159 pacientovi srozumiteln\u011b vysv\u011btl\u00ed zji\u0161t\u011bn\u00fd n\u00e1lez, jeho z\u00e1va\u017enost, dal\u0161\u00ed l\u00e9\u010debn\u00fd postup a odpov\u00ed na pacientovi dotazy.<\/p>\n Negativn\u00ed v\u00fdsledek LDCT<\/u><\/p>\n Je-li v\u00fdsledek negativn\u00ed, znamen\u00e1 to, \u017ee je pacient v\u00a0po\u0159\u00e1dku, nad\u00e1le v\u0161ak z\u016fst\u00e1v\u00e1 v\u00a0p\u00e9\u010di pneumologa a chod\u00ed na preventivn\u00ed kontroly v\u00a0ur\u010den\u00fdch intervalech (1 nebo 2 roky) podle sch\u00e9matu screeningov\u00e9ho vy\u0161et\u0159en\u00ed N\u00e1rodn\u00edho radiologick\u00e9ho standardu.\u00a0P\u0159i n\u00e1lezu jin\u00e9ho plicn\u00edho onemocn\u011bn\u00ed je pacient odesl\u00e1n zp\u011bt k pneumologovi ke komplexn\u00edmu vy\u0161et\u0159en\u00ed a p\u0159evzet\u00ed do p\u00e9\u010de.<\/p>\n \n Neur\u010dit\u00fd v\u00fdsledek LDCT<\/u><\/p>\n Pokud je v\u00fdsledek neur\u010dit\u00fd, pneumolog doporu\u010d\u00ed pacienta k opakovan\u00e9mu LDCT dle N\u00e1rodn\u00edho radiologick\u00e9ho standardu a d\u00e1le koordinuje p\u00e9\u010di o pacienta.<\/p>\n \n Pozitivn\u00ed v\u00fdsledek LDCT<\/u><\/p>\n V\u00a0p\u0159\u00edpad\u011b pozitivn\u00edho n\u00e1lezu do\u0161lo k\u00a0z\u00e1chytu onemocn\u011bn\u00ed karcinomu plic. Pneumolog zaji\u0161\u0165uje informov\u00e1n\u00ed pacienta o dal\u0161\u00edch podrobn\u00fdch vy\u0161et\u0159en\u00edch, ode\u0161le pacienta na pneumoonkochirurgick\u00e9 pracovi\u0161t\u011b KOC k multidisciplin\u00e1rn\u00edmu posouzen\u00ed a stanoven\u00ed postupu onkologick\u00e9 l\u00e9\u010dby.<\/p>\n \n \u00dahrada z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed<\/b><\/p>\n Ve\u0161ker\u00e1 vy\u0161et\u0159en\u00ed, kter\u00e1 jsou pacientovi indikov\u00e1na, jsou hrazena z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. V\u0161echna vy\u0161et\u0159en\u00ed je nutn\u00e9 prov\u00e9st ve\u00a0smluvn\u00edch zdravotnick\u00fdch za\u0159\u00edzen\u00edch<\/b>\u00a0(tedy u\u00a0poskytovatele zdravotn\u00edch slu\u017eeb, kter\u00fd m\u00e1 smlouvu se\u00a0zdravotn\u00ed poji\u0161\u0165ovnou pacienta).<\/p>\n \n Program \u010dasn\u00e9ho z\u00e1chytu karcinomu plic<\/b><\/p>\n Program \u010dasn\u00e9ho z\u00e1chytu karcinomu plic usiluje o zv\u00fd\u0161en\u00ed informovanosti lid\u00ed o rakovin\u011b plic a jej\u00ed p\u0159\u00edm\u00e9 souvislosti s kou\u0159en\u00edm, umo\u017e\u0148uje z\u00e1chyt \u010dasn\u00fdch, tedy vyl\u00e9\u010diteln\u00fdch stadi\u00ed karcinomu plic, je spojen s\u00a0programem odvyk\u00e1n\u00ed kou\u0159en\u00ed a umo\u017e\u0148uje tak\u00e9 \u010dasn\u00fd z\u00e1chyt dal\u0161\u00edch z\u00e1va\u017en\u00fdch onemocn\u011bn\u00ed plic l\u00e9\u010diteln\u00fdch dob\u0159e v \u010dasn\u00fdch stadi\u00edch (plicn\u00ed fibr\u00f3za, CHOPN \u2013 chronick\u00e1 obstruk\u010dn\u00ed bronchopulmon\u00e1ln\u00ed nemoc).<\/p>\n \n