Low-dose CT early lung cancer screening and risk factor analysis / 中华老年医学杂志

ABSTRACT

Objective To evaluate the value of screening with low-dose computed tomography (LDCT) for patients with early lung cancer and to identify risk factors.Methods A total of 53 202 asymptomatic participants admitted to Sichuan Provincial People's Hospital from October 2015 to July 2017 took LDCT for early lung cancer screening.Based on the National Comprehensive Cancer Network (NCCN) standard,participants were divided into a high-risk group (n=14 744),a moderaterisk group (n =22 341) and a low-risk group (n=16117),and the detection rates of lung nodules and lung cancer were analyzed.Results Of the 53 202 participants undergoing health examinations,35 808 (67.31％) had pulmonary nodules,including 6 640 (18.54％) with positive nodules,27 566 (76.98％) had solitary nodules,and 8 242 (23.02％) had multiple nodules.Out of 6 640 cases with positive modules,78 (11.75％) had lung cancer,with stage Ⅰ,stage Ⅱ,stage Ⅲ and stage Ⅳ making up 66.67％ (n=52),16.67％ (n=13),12.82％ (n=10) and 3.85％ (n=3) of the total.The high-risk group had significantly higher detection rates of lung nodules (81.23％,11 977/14 744),positive nodules (22.63％,n=2 710),multiple nodules (32.55％,3 898/11 977),and lung cancer (0.33％,48/14 744),compared with those in the moderate-risk group and the low-risk group (all P＜0.05).Smoking,long-term passive smoking and history of chronic obstructive pulmonary disorders were independent risk factors for lung cancer among screened subjects (OR =3.248,3.215,and 4.742,respectively,each P＜ 0.05).Conclusions LDCT is suitable for early lung cancer screening in asymptomatic subjects.Particular attention should be paid to those older than 55 years and those with a high smoking frequency ≥30 packs/year),long-term passive smoking,cancer history,family history of lung cancer,COPD or pulmonary fibrosis.