Zhang Zixuan, Gao Yinyan, Liu Shaohui, Ding Binrong, Zhang Xuewei, Wu Irene X Y
Xiangya School of Public Health, Central South University, Changsha, China.
Health Management Center, Xiangya Hospital, Central South University, Changsha, China.
Front Oncol. 2023 May 24;13:1085434. doi: 10.3389/fonc.2023.1085434. eCollection 2023.
Low-dose computed tomography (LDCT) has been promoted as a promising screening strategy for early detection of lung cancer. China released the latest lung cancer screening guideline in 2021. The compliance of the individuals who received LDCT for lung cancer screening with the guideline is unknown yet. It is necessary to summarize the distribution of guideline-defined lung cancer-related risk factors in the Chinese population so as to inform the selection of target population for the future lung cancer screening.
A single-center, cross-sectional study design was adopted. All participants were individuals who underwent LDCT at a tertiary teaching hospital in Hunan, China, between 1 January and 31 December 2021. LDCT results were derived along with guideline-based characteristics for descriptive analysis.
A total of 5,486 participants were included. Over one-quarter (1,426, 26.0%) of the participants who received screening did not meet the guideline-defined high-risk population, even among non-smokers (36.4%). Most of the participants (4,622, 84.3%) were found to have lung nodules, while no clinical intervention was required basically. The detection rate of positive nodules varied from 46.8% to 71.2% when using different cut-off values for positive nodules. Among non-smoking women, ground glass opacity appeared to be more significantly common compared with non-smoking men (26.7% vs. 21.8%).
Over one-quarter of individuals who received LDCT screening did not meet the guideline-defined high-risk populations. Appropriate cut-off values for positive nodules need to be continuously explored. More precise and localized criteria for high-risk individuals are needed, especially for non-smoking women.
低剂量计算机断层扫描（LDCT）已被推广为一种有前景的肺癌早期检测筛查策略。中国于2021年发布了最新的肺癌筛查指南。接受LDCT肺癌筛查的个体对该指南的依从性尚不清楚。有必要总结中国人群中指南定义的肺癌相关危险因素的分布情况，以便为未来肺癌筛查目标人群的选择提供参考。
采用单中心横断面研究设计。所有参与者均为2021年1月1日至12月31日期间在中国湖南一家三级教学医院接受LDCT检查的个体。获取LDCT结果以及基于指南的特征进行描述性分析。
共纳入5486名参与者。超过四分之一（1426名，26.0%）接受筛查的参与者不符合指南定义的高危人群标准，即使在非吸烟者中也是如此（36.4%）。大多数参与者（4622名，84.3%）被发现有肺结节，但基本无需临床干预。使用不同的阳性结节截断值时，阳性结节的检出率在46.8%至71.2%之间变化。在非吸烟女性中，磨玻璃影似乎比非吸烟男性更为常见（26.7%对21.8%）。
超过四分之一接受LDCT筛查的个体不符合指南定义的高危人群标准。需要不断探索合适的阳性结节截断值。需要更精确和本地化的高危个体标准，尤其是针对非吸烟女性。
