Henschke Claudia I, Yip Rowena, Boffetta Paolo, Markowitz Steven, Miller Albert, Hanaoka Takaomi, Wu Ning, Zulueta Javier J, Yankelevitz David F
Department of Radiology, Mount Sinai School of Medicine, New York, NY, United States.
Department of Radiology, Mount Sinai School of Medicine, New York, NY, United States; Institute of Translational Epidemiology, Mount Sinai School of Medicine, New York, NY, United States.
Lung Cancer. 2015 Apr;88(1):42-7. doi: 10.1016/j.lungcan.2015.01.014. Epub 2015 Feb 4.
To address the prevalence of lung cancer in high and low-risk people according to their smoking history, age, and CT findings of emphysema.
We reviewed the baseline low-dose CT scans of 62,124 current, former and never smokers, aged 40-90 to determine the prevalence of lung cancer. We performed logistic regression analysis of the prevalence of lung cancer to determine the odds ratio (OR) for emphysema, conditionally on age, female gender, and ethnicity.
The prevalence of lung cancer was 1.4% (95% CI: 1.3-1.6) for current smokers, 1.1% (95% CI: 1.0-1.2) for former smokers, and 0.4% (95% CI: 0.3-0.6) for never smokers. Emphysema was identified in 28.5% (6,684), 20.6% (5,422), and 1.6% (194) of current, former, and never smokers, respectively. The prevalence of lung cancer among current smokers was 1.1% for those without emphysema vs. 2.3% for those with emphysema (odds ratio [OR] 1.8; 95% confidence interval [CI]: 1.4-2.2) and the corresponding difference for former smokers was 0.9% vs. 1.8% (OR: 1.7; 95% CI: 1.3-2.2), and for never smokers, it was 0.4% vs. 2.6% (OR: 6.3; 95% CI: 2.4-16.9).
Identification of emphysema in low-dose CT scans increases the risk of lung cancer and is important in determining follow-up of current, former, and never smokers.
根据吸烟史、年龄和肺气肿的CT表现，探讨高风险和低风险人群中肺癌的患病率。
我们回顾了62124名年龄在40 - 90岁的当前吸烟者、既往吸烟者和从不吸烟者的基线低剂量CT扫描结果，以确定肺癌的患病率。我们对肺癌患病率进行逻辑回归分析，以确定在年龄、女性性别和种族条件下肺气肿的优势比（OR）。
当前吸烟者肺癌患病率为1.4%（95%CI：1.3 - 1.6），既往吸烟者为1.1%（95%CI：1.0 - 1.2），从不吸烟者为0.4%（95%CI：0.3 - 0.6）。当前吸烟者、既往吸烟者和从不吸烟者中肺气肿的检出率分别为28.5%（6684例）、20.6%（5422例）和1.6%（194例）。在当前吸烟者中，无肺气肿者肺癌患病率为1.1%，有肺气肿者为2.3%（优势比[OR]1.8；95%置信区间[CI]：1.4 - 2.2）；既往吸烟者相应的差异为0.9%对1.8%（OR：1.7；95%CI：1.3 - 2.2）；从不吸烟者为0.4%对2.6%（OR：6.3；95%CI：2.4 - 16.9）。
低剂量CT扫描中肺气肿的识别增加了肺癌风险，对确定当前吸烟者、既往吸烟者和从不吸烟者的随访具有重要意义。
