ABSTRACT
Importance: Lung cancer screening has been widely implemented in Europe and the US. However, there is little evidence on participation and diagnostic yields in population-based lung cancer screening in China. Objective: To assess the participation rate and detection rate of lung cancer in a population-based screening program and the factors associated with participation. Design, Setting, and Participants: This cross-sectional study used data from the Cancer Screening Program in Urban China from October 2013 to October 2019, with follow-up until March 10, 2020. The program is conducted at centers in 8 cities in Henan Province, China. Eligible participants were aged 40 to 74 and were evaluated for a high risk for lung cancer using an established risk score system. Main Outcomes and Measures: Overall and group-specific participation rates by common factors, such as age, sex, and educational level, were calculated. Differences in participation rates between those groups were compared. The diagnostic yield of both screening and nonscreening groups was calculated. Results: The study recruited 282â¯377 eligible participants and included 55â¯428 with high risk for lung cancer; the mean (SD) age was 55.3 (8.1) years, and 34â¯966 participants (63.1%) were men. A total of 22â¯260 participants underwent LDCT (participation rate, 40.16%; 95% CI, 39.82%-40.50%). The multivariable logistic regression model showed that female sex (odds ratio [OR], 1.64; 95% CI, 1.52-1.78), former smoking (OR, 1.26; 95% CI, 1.13-1.41), lack of physical activity (OR, 1.19; 95% CI, 1.14-1.24), family history of lung cancer (OR, 1.73; 95% CI, 1.66-1.79), and 7 other factors were associated with increased participation of LDCT screening. Overall, at 6-year follow-up, 78 participants in the screening group (0.35%; 95% CI, 0.29%-0.42%) and 125 in the nonscreening group (0.38%; 95% CI, 0.33%-0.44%) had lung cancer detected, which resulted in an odds ratio of 0.93 (95% CI, 0.70-1.23; P = .61). Conclusions and Relevance: The low participations rate in the program studied suggests that an improved strategy is needed. These findings may provide useful information for designing effective population-based lung cancer screening strategies in the future.
Subject(s)
Early Detection of Cancer/methods , Early Detection of Cancer/statistics & numerical data , Lung Neoplasms/diagnosis , Mass Screening/methods , Mass Screening/statistics & numerical data , Tomography, X-Ray Computed/methods , Adult , Aged , China , Cross-Sectional Studies , Female , Humans , Male , Middle AgedABSTRACT
Adipocyte-macrophage crosstalk plays a critical role to regulate adipose tissue microenvironment and cause chronic inflammation in the pathogenesis of obesity. Interleukin-29 (IL-29), a member of type 3 interferon family, plays a role in host defenses against microbes, however, little is known about its role in metabolic disorders. We explored the function of IL-29 in the pathogenesis of obesity-induced inflammation and insulin resistance. We found that serum IL-29 level was significantly higher in obese patients. IL-29 upregulated IL-1ß, IL-8, and monocyte chemoattractant protein-1 (MCP-1) expression and decreased glucose uptake and insulin sensitivity in human Simpson-Golabi-Behmel syndrome (SGBS) adipocytes through reducing glucose transporter 4 (GLUT4) and AKT signals. In addition, IL-29 promoted monocyte/macrophage migration. Inhibition of IL-29 could reduce inflammatory cytokine production in macrophage-adipocyte coculture system, which mimic an obese microenvironment. In vivo, IL-29 reduced insulin sensitivity and increased the number of peritoneal macrophages in high-fat diet (HFD)-induced obese mice. IL-29 increased M1/M2 macrophage ratio and enhanced MCP-1 expression in adipose tissues of HFD mice. Therefore, we have identified a critical role of IL-29 in obesity-induced inflammation and insulin resistance, and we conclude that IL-29 may be a novel candidate target for treating obesity and insulin resistance in patients with metabolic disorders.
Subject(s)
Inflammation/etiology , Insulin Resistance , Interferons/metabolism , Interleukins/metabolism , Obesity/complications , Adipocytes/pathology , Adipose Tissue/pathology , Animals , Arrhythmias, Cardiac/pathology , Cell Differentiation , Cell Movement , Chemokine CCL2/metabolism , Diet, High-Fat , Genetic Diseases, X-Linked/pathology , Gigantism/pathology , Glucose Transporter Type 4/metabolism , Heart Defects, Congenital/pathology , Inflammation/blood , Intellectual Disability/pathology , Interferons/blood , Interleukin-1beta/metabolism , Interleukin-6/metabolism , Interleukin-8/metabolism , Interleukins/blood , Lipopolysaccharides , Macrophages/drug effects , Macrophages/metabolism , Mice, Inbred C57BL , Mice, Obese , Obesity/blood , Phosphorylation , Proto-Oncogene Proteins c-akt/metabolism , Receptors, Interleukin/metabolism , Up-RegulationABSTRACT
The authors examined possible differences in left- and right-handers on bimanual reaction times to centralized visual stimuli. Eighty participants (n = 40 in each group of left- and right-handers) were tested on unimanual and bimanual reaction time (RT) tasks. Consistently across the 2 groups, the dominant-hand RT was faster, on average, than the nondominant-hand RT, and unimanual RTs were faster than bimanual RTs. However, RT differences between hands revealed a higher percentage of dominant-hand-led trials in right-handers than in left-handers, despite similar absolute RT differences in the 2 groups. On the basis of those findings, the authors conclude that hand dominance does not generally determine which hand leads in a bimanual task and that left-handers have stronger between-hemisphere competition than right-handers do.
