OBJECTIVES: To evaluate the performance of low-dose CT (LDCT) screening for lung cancer (LCA) detection in an Asian population with diverse risks for LCA. MATERIALS AND METHODS: LCA screening was performed in 12,427 symptomless Asian subjects using either LDCT (5,771) or chest radiography (CXR) (6,656) in a non-trial setting. Subjects were divided into high-risk and non-high-risk groups. Data were collected on the number of patients with screening-detected LCAs and their survival in order to compare outcomes between LDCT and CXR screening with the stratification of risks considering age, sex and smoking status. RESULTS: In the non-high-risk group, a significant difference was observed for the detection of lung cancer (adjusted OR, 5.07; 95 % CI, 2.72-9.45) and survival (adjusted HR of LCA survival between LDCT vs. CXR group, 0.08; 95 % CI, 0.01-0.62). No difference in detection or survival of LCA was noticed in the high-risk group. LCAs in the non-high-risk group were predominantly adenocarcinomas (96 %), and more likely to be part-solid or non-solid compared with those in the high-risk group (p = 0.023). CONCLUSIONS: In the non-high-risk group, LDCT helps detect more LCAs and offers better survival than CXR screening, due to better detection of part solid or non-solid lung adenocarcinomas. KEY POINTS: • In an Asian non-high-risk group, LDCT helps detect more early-staged LCAs. • CT-detected lung cancers in non-high-risk subjects demonstrate better survival than CXR-detected cancers. • CT-detected lung cancers in non-high-risk subjects are predominantly part-solid or non-solid adenocarcinomas. • Mortality benefit of LDCT screening in non-high-risk subjects needs to be investigated.
OBJECTIVES: To evaluate the performance of low-dose CT (LDCT) screening for lung cancer (LCA) detection in an Asian population with diverse risks for LCA. MATERIALS AND METHODS: LCA screening was performed in 12,427 symptomless Asian subjects using either LDCT (5,771) or chest radiography (CXR) (6,656) in a non-trial setting. Subjects were divided into high-risk and non-high-risk groups. Data were collected on the number of patients with screening-detected LCAs and their survival in order to compare outcomes between LDCT and CXR screening with the stratification of risks considering age, sex and smoking status. RESULTS: In the non-high-risk group, a significant difference was observed for the detection of lung cancer (adjusted OR, 5.07; 95 % CI, 2.72-9.45) and survival (adjusted HR of LCA survival between LDCT vs. CXR group, 0.08; 95 % CI, 0.01-0.62). No difference in detection or survival of LCA was noticed in the high-risk group. LCAs in the non-high-risk group were predominantly adenocarcinomas (96 %), and more likely to be part-solid or non-solid compared with those in the high-risk group (p = 0.023). CONCLUSIONS: In the non-high-risk group, LDCT helps detect more LCAs and offers better survival than CXR screening, due to better detection of part solid or non-solid lung adenocarcinomas. KEY POINTS: • In an Asian non-high-risk group, LDCT helps detect more early-staged LCAs. • CT-detected lung cancers in non-high-risk subjects demonstrate better survival than CXR-detected cancers. • CT-detected lung cancers in non-high-risk subjects are predominantly part-solid or non-solid adenocarcinomas. • Mortality benefit of LDCT screening in non-high-risk subjects needs to be investigated.
Authors: C I Henschke; D I McCauley; D F Yankelevitz; D P Naidich; G McGuinness; O S Miettinen; D M Libby; M W Pasmantier; J Koizumi; N K Altorki; J P Smith Journal: Lancet Date: 1999-07-10 Impact factor: 79.321
Authors: Hyae Young Kim; Kyu-Won Jung; Kun Young Lim; Soo-Hyun Lee; Jae Kwan Jun; Jeongseon Kim; Bin Hwangbo; Jin Soo Lee Journal: Cancer Res Treat Date: 2017-07-17 Impact factor: 4.679