Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.
Department of radiology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.
Cancer Med. 2024 Sep;13(18):e70184. doi: 10.1002/cam4.70184.
Low-dose computed tomography (LDCT) has emerged as a pivotal tool for detecting lung cancer among ever-smokers. This study aims to evaluate the gender-specific outcomes of LDCT screening within the Chinese never-smoking population.
We conducted a single-center, retrospective cohort study, which analyzed LDCT screening outcomes for 42,018 asymptomatic participants. Specifically, we focused on assessing gender-specific differences in the prevalence of pulmonary nodules, and the incidence of lung cancer diagnosis among never-smokers.
Among the 42,018 eligible participants, 41.50% were females and 58.50% were males. Most participants were non-smokers (77.57%), with a significantly higher proportion of non-smokers among females than males (99.33% vs. 62.14%). Pulmonary nodules were identified in 2.66% of participants, with a higher prevalence in females (2.99%) than males (2.43%) (p < 0.001). Non-smoking females had a higher incidence of positive nodules than non-smoking males (2.98% vs. 2.38%, p < 0.001). Invasive biopsies were performed in 334 individuals with nodules, confirming lung cancer in 258 cases. The majority of these cancer cases were non-smokers (212), with non-smoking females showing a higher incidence (0.85%) compared to males (0.43%) (p < 0.001). There was no significant difference in the false-positive rates between non-smoking females (0.14%) and males (0.13%). Multivariate analysis showed that never-smoking women were more likely to undergo biopsies (OR 1.65, p = 0.0016) and had a higher, though not statistically significant, probability of lung cancer diagnosis (OR 1.84, p = 0.06).
This study elucidates sex-based differences within the Chinese population, revealing a higher prevalence of pulmonary nodules and lung cancers among non-smoking females. These findings offer valuable reference for both clinical practice and future research initiatives.
低剂量计算机断层扫描（LDCT）已成为在长期吸烟者中检测肺癌的重要工具。本研究旨在评估 LDCT 筛查在中国从不吸烟人群中的性别特异性结果。
我们进行了一项单中心、回顾性队列研究，分析了 42018 名无症状参与者的 LDCT 筛查结果。具体而言，我们重点评估了在从不吸烟人群中，性别特异性肺结节患病率和肺癌诊断发生率的差异。
在 42018 名合格参与者中，41.50%为女性，58.50%为男性。大多数参与者为不吸烟者（77.57%），女性中不吸烟者的比例明显高于男性（99.33%比 62.14%）。在 2.66%的参与者中发现了肺结节，女性的患病率（2.99%）高于男性（2.43%）（p<0.001）。不吸烟的女性中，阳性结节的发生率高于不吸烟的男性（2.98%比 2.38%，p<0.001）。对 334 名有结节的患者进行了侵袭性活检，证实了 258 例肺癌。这些癌症病例大多数为不吸烟者（212 例），其中不吸烟的女性发病率（0.85%）高于男性（0.43%）（p<0.001）。不吸烟的女性（0.14%）和男性（0.13%）的假阳性率没有显著差异。多变量分析表明，从不吸烟的女性更有可能接受活检（OR 1.65，p=0.0016），并且尽管没有统计学意义，但肺癌诊断的可能性更高（OR 1.84，p=0.06）。
本研究阐明了中国人群中的性别差异，揭示了不吸烟女性中肺结节和肺癌的患病率更高。这些发现为临床实践和未来的研究计划提供了有价值的参考。
