Chen Keyi, Yin Yanze, Wang Chao, Zeng Ao, Fang Xinyun, Abuduwayiti Abudumijiti, Xu Zhilong, Dai Jie, Jiang Gening
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Transl Lung Cancer Res. 2024 Nov 30;13(11):2880-2889. doi: 10.21037/tlcr-24-475. Epub 2024 Nov 13.
In 2021, the US Preventive Services Task Force expanded the initial age for lung cancer screening from 55 to 50 years, which other associations have not followed. The objective of this study was to evaluate the beneficiary age range for lung cancer screening and assess the potential heterogeneity in tumor histology and patient sex.
Using the Surveillance, Epidemiology, and End Results database, patients with non-small cell lung cancer (NSCLC) between 2011 and 2016 were included. The estimation of overall survival (OS) and lung cancer-specific survival (LCSS) was conducted for survival analysis among three different age groups: 45-49 (n=4,203), 50-54 (n=10,126), and 55-59 years (n=17,122), adjusting for other clinicopathological characteristics.
Significant differences were observed in OS {hazard ratio (HR) [95% confidence interval (CI)]: 0.94 (0.92-0.96)} and LCSS [HR (95% CI): 0.94 (0.91-0.97)] for patients aged 50-54 compared to those aged 55-59. However, no survival advantage was observed for patients aged 45-49 [HR (95% CI) for OS: 0.97 (0.93-1.01), HR (95% CI) for LCSS: 0.98 (0.93-1.02)]. Similar survival trends were observed in patients with adenocarcinoma whereas no difference among those with squamous cell carcinoma across all age groups. Among patients aged 40-45, we observed a significant survival advantage for males, with no corresponding advantage in females.
Patients aged 50 to 54 can benefit from lung cancer screening, in accordance with the recommendations of the US Preventive Services Task Force (USPSTF). The benefits are probably more apparent in adenocarcinoma cases. Younger male patients may benefit more than female patients, which may reflect the need for sex differences in cancer screening.
2021年，美国预防服务工作组将肺癌筛查的起始年龄从55岁扩大到50岁，其他协会尚未效仿。本研究的目的是评估肺癌筛查的受益年龄范围，并评估肿瘤组织学和患者性别的潜在异质性。
使用监测、流行病学和最终结果数据库，纳入2011年至2016年间的非小细胞肺癌（NSCLC）患者。对三个不同年龄组（45 - 49岁，n = 4203；50 - 54岁，n = 10126；55 - 59岁，n = 17122）进行总生存期（OS）和肺癌特异性生存期（LCSS）的估计，以进行生存分析，并对其他临床病理特征进行调整。
与55 - 59岁的患者相比，50 - 54岁的患者在OS（风险比[HR][95%置信区间（CI）]：0.94[0.92 - 0.96]）和LCSS[HR（95%CI）：0.94（0.91 - 0.97）]方面存在显著差异。然而，45 - 49岁的患者未观察到生存优势[OS的HR（95%CI）：0.97（0.93 - 1.01），LCSS的HR（95%CI）：0.98（0.93 - 1.02）]。腺癌患者观察到类似的生存趋势，而鳞状细胞癌患者在所有年龄组中无差异。在40 - 45岁的患者中，我们观察到男性有显著的生存优势，女性则无相应优势。
根据美国预防服务工作组（USPSTF）的建议，50至54岁的患者可从肺癌筛查中受益。这种益处可能在腺癌病例中更为明显。年轻男性患者可能比女性患者受益更多，这可能反映了癌症筛查中性别差异的必要性。
