多个肺癌筛查研究报道了肺部CT筛查报告与数据系统（Lung-RADS）的表现，但没有其中对不同人群的表现进行系统评估。本系统评价和荟萃分析旨在评估Lung-RADS（版本1.0和1.1）在不同人群中检测肺癌的表现。我们于2022年10月21日，在PubMed、Web of Science、Cochrane Library和Embase数据库中进行文献搜索，寻找评估Lung-RADS在肺癌筛查中准确性的研究。采用双变量随机效应模型估计合并敏感性和特异性，并利用分层和荟萃回归分析探索异质性。共纳入了31项研究，参与人数为104,224人。对于1.0版本（27项研究，95,413个个体），合并敏感性为0.96（95%置信区间[CI]：0.90-0.99），合并特异性为0.90（95% CI：0.87-0.92）。高风险人群的研究显示出较高的敏感性（0.98 [95% CI：0.92-0.99] vs. 0.84 [95% CI：0.50-0.96]）和较低的特异性（0.87 [95% CI：0.85-0.88] vs. 0.95 [95% CI：0.92-0.97]）比一般人群的研究。非亚洲研究倾向于具有较高的敏感性（0.97 [95% CI：0.91-0.99] vs. 0.91 [95% CI：0.67-0.98]）和较低的特异性（0.88 [95% CI：0.85-0.90] vs. 0.93 [95% CI：0.88-0.96]）比亚洲研究。对于1.1版本（4项研究，8811个个体），合并敏感性为0.91（95% CI：0.83-0.96），特异性为0.81（95% CI：0.67-0.90）。在使用Lung-RADS 1.0版本的研究中，敏感性和特异性存在相当大的异质性，可以通过人群类型（高风险 vs 一般）、人群区域（亚洲 vs 非亚洲）和癌症患病率来解释。利用Lung-RADS 1.0版本的肺癌筛查研究的荟萃分析显示，敏感性和特异性存在相当大的异质性，可以通过不同的目标人群来解释，包括高风险人群与一般人群、亚洲与非亚洲人群以及患有不同肺癌患病率的人群。• 使用Lung-RADS 1.0版本的高风险人群研究与一般人群研究相比，敏感性更高，特异性更低。• 在非亚洲研究中，Lung-RADS 1.0版本的诊断表现往往好于亚洲研究。• 对于Lung-RADS 1.1版本的性能研究有限，对亚洲人群缺乏证据。© 2023. 作者。

Multiple lung cancer screening studies reported the performance of Lung CT Screening Reporting and Data System (Lung-RADS), but none systematically evaluated its performance across different populations. This systematic review and meta-analysis aimed to evaluate the performance of Lung-RADS (versions 1.0 and 1.1) for detecting lung cancer in different populations.We performed literature searches in PubMed, Web of Science, Cochrane Library, and Embase databases on October 21, 2022, for studies that evaluated the accuracy of Lung-RADS in lung cancer screening. A bivariate random-effects model was used to estimate pooled sensitivity and specificity, and heterogeneity was explored in stratified and meta-regression analyses.A total of 31 studies with 104,224 participants were included. For version 1.0 (27 studies, 95,413 individuals), pooled sensitivity was 0.96 (95% confidence interval [CI]: 0.90-0.99) and pooled specificity was 0.90 (95% CI: 0.87-0.92). Studies in high-risk populations showed higher sensitivity (0.98 [95% CI: 0.92-0.99] vs. 0.84 [95% CI: 0.50-0.96]) and lower specificity (0.87 [95% CI: 0.85-0.88] vs. 0.95 (95% CI: 0.92-0.97]) than studies in general populations. Non-Asian studies tended toward higher sensitivity (0.97 [95% CI: 0.91-0.99] vs. 0.91 [95% CI: 0.67-0.98]) and lower specificity (0.88 [95% CI: 0.85-0.90] vs. 0.93 [95% CI: 0.88-0.96]) than Asian studies. For version 1.1 (4 studies, 8811 individuals), pooled sensitivity was 0.91 (95% CI: 0.83-0.96) and specificity was 0.81 (95% CI: 0.67-0.90).Among studies using Lung-RADS version 1.0, considerable heterogeneity in sensitivity and specificity was noted, explained by population type (high risk vs. general), population area (Asia vs. non-Asia), and cancer prevalence.Meta-regression of lung cancer screening studies using Lung-RADS version 1.0 showed considerable heterogeneity in sensitivity and specificity, explained by the different target populations, including high-risk versus general populations, Asian versus non-Asian populations, and populations with different lung cancer prevalence.• High-risk population studies showed higher sensitivity and lower specificity compared with studies performed in general populations by using Lung-RADS version 1.0. • In non-Asian studies, the diagnostic performance of Lung-RADS version 1.0 tended to be better than in Asian studies. • There are limited studies on the performance of Lung-RADS version 1.1, and evidence is lacking for Asian populations.© 2023. The Author(s).