One-time low-dose CT scan useful for lung cancer screening

Lung cancer screening with a single low-dose CT scan was associated with a significant reduction in lung cancer incidence and all-cause mortality. These results emerged from a nationwide lung cancer screening program from China recently in Lancet Respiratory Medicine†

This prospective cohort study was conducted in 12 Chinese cities. The subjects recruited were between the ages of 40 and 74, and had no symptoms of lung cancer and no history of lung cancer. Over a million people have been evaluated for suitability. Almost all of them participated in this study.

Lung cancer was diagnosed in 3,581 people after a median follow-up of 3.6 years. When estimating lung cancer risk, smoking status, physical activity, occupational exposure, history of chronic respiratory disease, family history, diet, and secondhand smoke (in women only) were taken into account. More than 220,000 participants with a high risk of lung cancer were invited for a one-time LDCT scan. Low-dose CT scans were performed in 35.6%.

In the screened group, the incidence of lung cancer was 47.0% higher than in the unscreened group (hazard ratio 1.47). However, lung cancer mortality decreased by 31.0% (HR 0.69) and lowest all-cause mortality rate by 32.0% (HR 0.68).

These results suggest that low-dose CT scanning may be useful in countries with few health-care facilities. To develop population-specific screening strategies, further research into the interactions of each subgroup, including gender, age, smoking status, and economic status, is required.

source:
Li N, Tan F, Chen W, et al. One-time low-dose computed tomography for lung cancer screening in China: a prospective, multicenter, population-based cohort study. Lancet Resper Med. 2022; 10: 378-91.