Initial low-dose computed tomography screening results and summary of participant characteristics: based on the latest Chinese guideline

Zixuan Zhang; Yinyan Gao; Shaohui Liu; Binrong Ding; Xuewei Zhang; Irene X Y Wu

doi:10.3389/fonc.2023.1085434

Initial low-dose computed tomography screening results and summary of participant characteristics: based on the latest Chinese guideline

Front Oncol. 2023 May 24:13:1085434. doi: 10.3389/fonc.2023.1085434. eCollection 2023.

Authors

Zixuan Zhang¹, Yinyan Gao¹, Shaohui Liu², Binrong Ding³, Xuewei Zhang^{2

4

5}, Irene X Y Wu^{1

6}

Affiliations

¹ Xiangya School of Public Health, Central South University, Changsha, China.
² Health Management Center, Xiangya Hospital, Central South University, Changsha, China.
³ Department of Geriatrics, The Third Xiangya Hospital, Central South University, Changsha, China.
⁴ Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China.
⁵ National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
⁶ Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China.

Abstract

Background: Low-dose computed tomography (LDCT) has been promoted as a promising screening strategy for early detection of lung cancer. China released the latest lung cancer screening guideline in 2021. The compliance of the individuals who received LDCT for lung cancer screening with the guideline is unknown yet. It is necessary to summarize the distribution of guideline-defined lung cancer-related risk factors in the Chinese population so as to inform the selection of target population for the future lung cancer screening.

Methods: A single-center, cross-sectional study design was adopted. All participants were individuals who underwent LDCT at a tertiary teaching hospital in Hunan, China, between 1 January and 31 December 2021. LDCT results were derived along with guideline-based characteristics for descriptive analysis.

Results: A total of 5,486 participants were included. Over one-quarter (1,426, 26.0%) of the participants who received screening did not meet the guideline-defined high-risk population, even among non-smokers (36.4%). Most of the participants (4,622, 84.3%) were found to have lung nodules, while no clinical intervention was required basically. The detection rate of positive nodules varied from 46.8% to 71.2% when using different cut-off values for positive nodules. Among non-smoking women, ground glass opacity appeared to be more significantly common compared with non-smoking men (26.7% vs. 21.8%).

Conclusion: Over one-quarter of individuals who received LDCT screening did not meet the guideline-defined high-risk populations. Appropriate cut-off values for positive nodules need to be continuously explored. More precise and localized criteria for high-risk individuals are needed, especially for non-smoking women.

Keywords: characteristics; low-dose computed tomography; lung cancer; non-smokers; screening.

Grants and funding

This research received a grant from National Key Research and Development Program “Active Health and Technology Response to Aging” key special project (2018YFC2000300).