Department of Cancer Prevention, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China.
Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China.
Cancer Epidemiol. 2020 Dec;69:101801. doi: 10.1016/j.canep.2020.101801. Epub 2020 Oct 2.
To evaluate the performance of low-dose computed tomography (LDCT) on lung cancer screening in high-risk populations in Sichuan.
From April 2014 to July 2018, LDCT was performed annually on 3185 subjects aged 50-74 years who had smoked ≥ 20 pack-years (or subjects having quit smoking within 5 years). Information about all deaths and lung cancer diagnoses were obtained by active investigation, or passive matching to disease surveillance system.
The screening population had a median age of 60 years. 62.4 % of which were current smokers and had smoked 30 pack-years. After participating in the baseline screening, the compliance rates of subjects consecutively completing one round, two rounds, three rounds, and four rounds of annual screening were 67.22 %, 52.84 %, 43.24 %, and 40.04 %, respectively. The positive rates in baseline and annual screening were 6.53 % and 5.79 %, respectively. During the 5 rounds, a total of 9522 person-times were screened by LDCT with a screening sensitivity of 89.13 % (95 % CI: 76.96-95.27), specificity of 94.36 % (95 % CI: 93.88-94.81), positive predictive value of 7.13 % (95 % CI: 5.30-9.53), and negative predictive value of 99.94 % (95 % CI: 99.87-99.98). There were no statistically significant performance differences between baseline and annual screening. The difference in the proportion of screen-detected stage I lung cancer between baseline screening and annual screening was not statistically significant, neither.
The application of LDCT on lung cancer screening in high-risk populations shows favorable compliance and a high screening performance in the project area of Sichuan,China.
评估低剂量计算机断层扫描（LDCT）在四川高危人群肺癌筛查中的表现。
2014 年 4 月至 2018 年 7 月，对 3185 名年龄在 50-74 岁、吸烟≥20 包年（或戒烟 5 年内）的人群进行了每年一次的 LDCT 检查。通过主动调查或被动匹配疾病监测系统获得所有死亡和肺癌诊断的信息。
筛查人群的中位年龄为 60 岁。其中 62.4%为当前吸烟者，吸烟 30 包年。参加基线筛查后，连续完成一轮、两轮、三轮和四轮年度筛查的受试者依从率分别为 67.22%、52.84%、43.24%和 40.04%。基线和年度筛查的阳性率分别为 6.53%和 5.79%。在 5 轮中，共对 9522 人次进行了 LDCT 筛查，筛查敏感度为 89.13%（95%置信区间：76.96%-95.27%），特异度为 94.36%（95%置信区间：93.88%-94.81%），阳性预测值为 7.13%（95%置信区间：5.30%-9.53%），阴性预测值为 99.94%（95%置信区间：99.87%-99.98%）。基线和年度筛查的性能差异无统计学意义。基线筛查和年度筛查中Ⅰ期肺癌的检出率差异也无统计学意义。
在中国四川项目地区，高危人群肺癌筛查中应用 LDCT 具有良好的依从性和较高的筛查性能。
