Screening baseline characteristics of early lung cancer on low-dose computed tomography with computer-aided detection in a Chinese population

• Published in: Cancer epidemiology Vol. 62; p. 101567
• Main Authors: Liu, Yuanyuan, Luo, Hongbin, Qing, Haomiao, Wang, Xiaodong, Ren, Jing, Xu, Guohui, Hu, Shibei, He, Changjiu, Zhou, Peng
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.10.2019; Elsevier Limited
• Subjects: Aged; CAD; Cancer; Cancer screening; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - epidemiology; China; Clinical medicine; Computed tomography; Early Detection of Cancer - methods; Epidemiology; Female; Guideline; Humans; LDCT; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - epidemiology; Male; Mass Screening - methods; Medical screening; Middle Aged; Mortality; Non-small cell lung carcinoma; Population; Population studies; Small cell lung carcinoma; Smoking; Software; Tobacco smoke; Tomography; Tomography, X-Ray Computed - methods; Work stations; China; Beijing China; Guideline; LDCT; Lung cancer; CAD
• DOI: 10.1016/j.canep.2019.101567
• ISSN: 1877-7821; 1877-783X

•It is not clear whether the LDCT screening criteria of American or European countries is appropriate for China.•According to the NCCN criteria, only 54 women were included and 1 of these (1.8%) developed lung cancer.•A non-calcified nodule size ≥5 mm at baseline characterized 20.4% positivity of our population; the false positive rate was 19.5%.•Further studies are warranted to establish appropriate eligible criteria and management strategies for the Chinese population. This study investigated appropriate baseline characteristics for screening a Chinese population at high risk of early lung cancer, assisted by low-dose computed tomography (LDCT) with computer-aided detection (CAD). Included is a discussion of the viability of using LDCT in the screening guideline and optimizing the guideline. In 2014, 1016 individuals from Sichuan Province were enrolled who satisfied the criteria for high risk according to the 2013 National Comprehensive Cancer Network (NCCN) Guidelines for Non-Small Cell Lung Cancer. From 2014 to 2018, each subject was followed using LDCT with CAD, and pathologically confirmed lung cancers and baseline nodule characteristics (size and density) were recorded. Positive risk was considered a non-calcified solid or part-solid nodule on LDCT with diameter ≥5 mm and ground-glass nodule ≥8 mm, as newly recommended by the China National Lung Cancer Screening Guideline. From 2014–2018, 13 cases of lung cancer were detected; 5 of these were early stage (38.5%). According to the NCCN criteria, 54 women were included and one of these (1.8%) developed lung cancer. The prevalence of lung cancer was 0.7% at baseline. For the entire population (excluding subjects with a tumor mass at baseline, n = 4), the rate of positivity was 20.4% at baseline; applying the Chinese criteria, the false positive rate was 19.5% (197/1012). Further studies are warranted to establish appropriate eligible criteria and management strategies for Chinese populations.