Chinese Journal of Lung Cancer (May 2024)

Results of Lung Cancer Screening with Low-dose Computed Tomography 
and Exploration of Risk Factors in Guangzhou

  • Xuanzhuang LU,
  • Qiuxia QIU,
  • Chunyu YANG,
  • Caichen LI,
  • Jianfu LI,
  • Shan XIONG,
  • Bo CHENG,
  • Chujing ZHOU,
  • Xiaoqin DU,
  • Yi ZHANG,
  • Jianxing HE,
  • Wenhua LIANG,
  • Nanshan ZHONG

DOI
https://doi.org/10.3779/j.issn.1009-3419.2024.101.14
Journal volume & issue
Vol. 27, no. 5
pp. 345 – 358

Abstract

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Background and objective Both of lung cancer incidence and mortality rank first among all cancers in China. Previous lung cancer screening trials were mostly selective screening for high-risk groups such as smokers. Non-smoking women accounted for a considerable proportion of lung cancer cases in Asia. This study aimed to evaluate the outcome of community-based mass screening in Guangzhou and identify the high-risk factors for lung cancer. Methods Residents aged 40-74 years in Guangzhou were screened with low-dose computed tomography (LDCT) for lung cancer and the pulmonary nodules were classified and managed according to China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2018 version). The detection rate of positive nodules was calculated. Before the LDCT examination, residents were required to complete a "lung cancer risk factors questionnaire". The risk factors of the questionnaire were analyzed by least absolute shrinkage and selection operator (LASSO) penalized Logistic regression analysis. Results A total of 6256 residents were included in this study. 1228 positive nodules (19.63%) and 117 lung cancers were confirmed, including 6 cases of Tis, 103 cases of stage I (accounting for 88.03% of lung cancer). The results of LASSO penalized Logistic regression analysis indicated that age ≥50 yr (OR=1.07, 95%CI: 1.06-1.07), history of cancer (OR=3.29, 95%CI: 3.22-3.37), textile industry (OR=1.10, 95%CI: 1.08-1.13), use coal for cooking in childhood (OR=1.14, 95%CI: 1.13-1.16) and food allergy (OR=1.10, 95%CI: 1.07-1.13) were risk factors of lung cancer for female in this district. Conclusion This study highlighted that numerous early stages of lung cancer cases were detected by LDCT, which could be applied to screening of lung cancer in women. Besides, age ≥50 yr, personal history of cancer, textile industry and use coal for cooking in childhood are risk factors for women in this district, which suggested that it’s high time to raise the awareness of early lung cancer screening in this group.

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