Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Sci Rep. 2019 Dec 18;9(1):19386. doi: 10.1038/s41598-019-56025-6.
Screening programs for lung cancer aim to allow diagnosis at the early stage, and therefore the decline in mortality rates. Thus, the aim of this retrospective cohort study was to the comparison of screened and non-screened lung cancer in terms of lung cancer characteristics, overdiagnosis and survival rate. A retrospective study in which 2883 patients with 2883 lung cancer diagnosed according to the hospital-based lung cancer register database between 2007 and 2017. A comparison was performed in term of clinical characteristics and outcomes of lung cancer between the screened and non-screening patient groups. 2883 subjects were identified (93 screened and 2790 non-screened). Screened group patients were younger (59.91 ± 8.14 versus 67.58 ± 12.95; p < 0.0001), and were more likely to be female than non-screened group (61.3% versus 36.8%; p < 0.0001). The screened group showed significantly better outcomes in overall mortality than the non-screened group (10.75% versus 79.06%; <0.0001). In a Cox proportional hazard model, lung cancer in the screened group proved to be an independent prognostic factor in lung cancer subjects. Our findings point to the improved survival outcome in the screened group and might underline the benefit of low-dose computed tomography (LDCT) screening program in Asian populations with the high prevalence of non-smoking-related lung cancer. Further study aimed at the LDCT mass screening program targeting at light smokers and non-smoker outside of existing screening criteria is warranted.
肺癌筛查项目旨在实现早期诊断,从而降低死亡率。因此,本回顾性队列研究旨在比较筛查和未筛查肺癌在肺癌特征、过度诊断和生存率方面的差异。该回顾性研究纳入了 2007 年至 2017 年间根据医院肺癌登记数据库诊断的 2883 例肺癌患者和 2883 例肺癌患者。比较了筛查组和非筛查组患者的临床特征和肺癌结局。共纳入 2883 例患者(93 例筛查组和 2790 例非筛查组)。筛查组患者更年轻(59.91±8.14 岁 vs. 67.58±12.95 岁;p<0.0001),且女性比例高于非筛查组(61.3% vs. 36.8%;p<0.0001)。与非筛查组相比,筛查组的总死亡率显著降低(10.75% vs. 79.06%;p<0.0001)。在 Cox 比例风险模型中,筛查组的肺癌是肺癌患者的独立预后因素。我们的研究结果表明,筛查组的生存结果得到改善,这可能强调了低剂量计算机断层扫描(LDCT)筛查计划在非吸烟相关肺癌高发的亚洲人群中的益处。需要进一步研究针对轻度吸烟者和现有筛查标准之外的非吸烟者的 LDCT 大规模筛查计划。