癌症筛查试验被推广作为延长寿命的方法，但人们是否会因常用的癌症筛查试验而活得更久尚不得而知。为评估通过癌症筛查获得的寿命。我们进行了一项系统综述和荟萃分析，选择了9年以上的随访时间的随机临床试验作为研究对象，报告了各种常用癌症筛查试验的全因死亡率和估计的寿命增益，并将筛查与不筛查进行对比。分析对象为普通人群。我们检索了MEDLINE数据库和Cochrane库数据库，并进行了最后一次检索，检索时间为2022年10月12日。癌症筛查试验包括乳腺癌乳房造影筛查、结肠癌结肠镜检查、乙状结肠镜检查或粪便隐藏血试验（FOBT）肠癌筛查、吸烟者和曾吸烟者肺癌的计算机断层扫描筛查，以及前列腺特异性抗原检测前列腺癌。我们按照“系统评价和荟萃分析报告优选报告项目”（PRISMA）的报告指南进行了检索和筛选。数据由单一观察者独立提取，并进行临床试验的汇总分析用于分析。筛查获得的增加的寿命年被计算为筛查组与未筛查组之间观察到的寿命差别，并根据荟萃分析或单个随机临床试验计算了95％置信区间内每种筛查试验的绝对寿命增益的天数。总共有2,111,958名参与了将筛查与不筛查使用不同筛查试验进行随机临床试验的人员符合资格。计算机断层扫描、前列腺特异性抗原检测和结肠镜检查的中位随访时间为10年；乳腺乳房造影筛查的随访时间为13年；乙状结肠镜检查和FOBT的随访时间为15年。唯一有显着寿命增益的筛查试验是乙状结肠镜检查（110天；95％CI，0-274天）。乳腺癌筛查（0天；95％CI，-190至237天）、前列腺癌筛查（37天；95％CI，-37至73天）、结肠镜检查（37天；95％CI，-146至146天）、每年或每隔一年进行的FOBT筛查（0天；95％CI，-70.7至70.7天）和肺癌筛查（107天；95％CI，-286至430天）均没有显着差异。这项荟萃分析的结果表明，目前的证据不支持常用癌症筛查试验可以通过延长寿命来挽救生命，除非是结肠癌筛查的乙状结肠镜检查。

Cancer screening tests are promoted to save life by increasing longevity, but it is unknown whether people will live longer with commonly used cancer screening tests.To estimate lifetime gained with cancer screening.A systematic review and meta-analysis was conducted of randomized clinical trials with more than 9 years of follow-up reporting all-cause mortality and estimated lifetime gained for 6 commonly used cancer screening tests, comparing screening with no screening. The analysis included the general population. MEDLINE and the Cochrane library databases were searched, and the last search was performed October 12, 2022.Mammography screening for breast cancer; colonoscopy, sigmoidoscopy, or fecal occult blood testing (FOBT) for colorectal cancer; computed tomography screening for lung cancer in smokers and former smokers; or prostate-specific antigen testing for prostate cancer.Searches and selection criteria followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Data were independently extracted by a single observer, and pooled analysis of clinical trials was used for analyses.Life-years gained by screening was calculated as the difference in observed lifetime in the screening vs the no screening groups and computed absolute lifetime gained in days with 95% CIs for each screening test from meta-analyses or single randomized clinical trials.In total, 2 111 958 individuals enrolled in randomized clinical trials comparing screening with no screening using 6 different tests were eligible. Median follow-up was 10 years for computed tomography, prostate-specific antigen testing, and colonoscopy; 13 years for mammography; and 15 years for sigmoidoscopy and FOBT. The only screening test with a significant lifetime gain was sigmoidoscopy (110 days; 95% CI, 0-274 days). There was no significant difference following mammography (0 days: 95% CI, -190 to 237 days), prostate cancer screening (37 days; 95% CI, -37 to 73 days), colonoscopy (37 days; 95% CI, -146 to 146 days), FOBT screening every year or every other year (0 days; 95% CI, -70.7 to 70.7 days), and lung cancer screening (107 days; 95% CI, -286 days to 430 days).The findings of this meta-analysis suggest that current evidence does not substantiate the claim that common cancer screening tests save lives by extending lifetime, except possibly for colorectal cancer screening with sigmoidoscopy.