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2014年至2019年北京城区肺癌筛查

[Lung cancer screening in urban Beijing from 2014 to 2019].

作者信息

Yang L, Zhang X, Liu S, Li H C, Li Q Y, Wang N, Ji J F

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2021 Mar 6;55(3):339-345. doi: 10.3760/cma.j.cn112150-20200817-01126.

Abstract

To analyze the current status of lung cancer screening among residents in Urban Beijing Cancer Screening Program, 2014-2019. Based on an on-going cancer screening program launched by the National Urban Cancer Screening Program, residents aged 40 to 69 were recruited from 80 streets in six districts of Beijing (Dongcheng, Xicheng, Chaoyang, Haidian, Fengtai, and Shijingshan District) by using a cluster sampling method. Subjects who were evaluated as high-risk individuals by using the questionnaire received Low-Dose spiral Computed Tomography (LDCT) screening in designated hospitals. All participants were followed up annually using active and passive follow-up methods to obtain their health outcomes (diagnosed with lung cancer or not). The proportion of high-risk cases evaluated by using the questionnaire, clinical recall rate for receiving LDCT screening, the proportion of cases with positive pulmonary node, incidence rate, cumulative incidence rate, and the proportion of patients with stage 0 or Ⅰ were calculated. Cox proportional hazard regression model was used to estimate the hazard ratio () and 95% confidence interval (95%) among individuals who experienced different screening scenarios. A total of 88 044 residents with the age of (57.4±7.4) with completed high-risk assessment were included in the analysis. 23.14% of participants were evaluated as high-risk individuals by using the questionnaire. The clinical recall rate was 52.26% among the high-risk individuals. The positive rate of pulmonary node detected by LDCT was 10.99%. The incidence rate of lung cancer among males and females aged 40-69 years were 172.82/100 000 person-years and 133.52/100 000 person-years, respectively after 3 years follow-up. The incidence rates increased with age (<0.001). The incidence rate of lung cancer among high-risk individuals was 259.22/100 000 person-years, with the () about 2.27 (1.83-2.81) when compared with that among low-risk individuals. The incidence rate and cumulative incidence rate of lung cancer among individuals with positive pulmonary node detected by LDCT were 1 825.03/100 000 person-years and 4 615.38/100 000, respectively, with the (95% about 13.80 (8.91-21.36) when compared with that among individuals with no or negative pulmonary node. The early diagnosis rate among individuals who received LDCT screening was 70.21%, which was higher than that among individuals with no LDCT screening (45.45%). Individuals with a high risk of lung cancer in Beijing have a better recall rate of receiving LDCT screening. Using LDCT screening among high-risk individuals is an effective strategy to detect lung cancer cases and improve the early detection rates of lung cancer in Beijing, China.

摘要

分析2014 - 2019年北京市城市癌症筛查项目中肺癌筛查的现状。基于国家城市癌症筛查项目正在进行的癌症筛查项目,采用整群抽样方法从北京市六个区(东城区、西城区、朝阳区、海淀区、丰台区和石景山区)的80条街道招募40至69岁的居民。通过问卷评估为高危个体的受试者在指定医院接受低剂量螺旋计算机断层扫描(LDCT)筛查。采用主动和被动随访方法对所有参与者进行年度随访,以获取他们的健康结局(是否被诊断为肺癌)。计算通过问卷评估的高危病例比例、接受LDCT筛查的临床召回率、肺结节阳性病例比例、发病率、累积发病率以及0期或Ⅰ期患者的比例。使用Cox比例风险回归模型估计经历不同筛查方案的个体之间的风险比()和95%置信区间(95%)。共有88044名年龄为(57.4±7.4)岁且完成高危评估的居民纳入分析。23.14%的参与者通过问卷评估为高危个体。高危个体的临床召回率为52.26%。LDCT检测到的肺结节阳性率为10.99%。经过3年随访,40 - 69岁男性和女性的肺癌发病率分别为172.82/10万/人年和133.52/10万/人年。发病率随年龄增加而升高(<0.001)。高危个体的肺癌发病率为259.22/10万/人年,与低危个体相比,风险比()约为2.27(1.83 - 2.81)。LDCT检测到肺结节阳性的个体中肺癌的发病率和累积发病率分别为1825.03/10万/人年和4615.38/10万,与肺结节无或阴性的个体相比,风险比(95%)约为13.80(8.91 - 21.36)。接受LDCT筛查的个体的早期诊断率为70.21%,高于未接受LDCT筛查的个体(45.45%)。北京肺癌高危个体接受LDCT筛查的召回率较好。对高危个体使用LDCT筛查是在中国北京检测肺癌病例并提高肺癌早期检出率的有效策略。

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