One-off low-dose CT screening of positive nodules in lung cancer: A prospective community-based cohort study.

BACKGROUND: To improve the early stage diagnosis and reduce the lung cancer (LC) mortality for positive nodule (PN) population, data on effectiveness of PN detection using one-off low-dose spiral computed tomography (LDCT) screening are needed to improve the PN management protocol. We evaluate the effectiveness of PN detection and developed a nomogram to predict LC risk for PNs. METHODS: A prospective, community-based cohort study was conducted. We recruited 292,531 eligible candidates during 2012-2018. Individuals at high risk of LC based on risk assessment underwent LDCT screening and were divided into PN and non-PN groups. The effectiveness of PN detection was evaluated in LC incidence, mortality, and all-cause mortality. We performed subgroup analysis of characteristic variables for the association between PN and LC risk. A competing risk model was used to develop the nomogram. RESULTS: Participants (n = 14901) underwent LDCT screening; PNs were detected in 1193 cases (8·0%). After a median follow-up of 6·1 years, 193 were diagnosed with LC (1·3%). Of these, 94 were in the PN group (8·0%). LC incidence, mortality, and all-cause mortality were significantly higher in the PN group (adjusted hazard ratios: 10.60 (7.91-14.20), 7.97 (5.20-12.20), and 1.94 (1.51-2.50), respectively). Additionally, various PN characteristics were associated with an increased probability of developing LC. The C-index value of the nomogram for predicting LC risk of PN individuals was 0·847. CONCLUSIONS: The protocol of PNs management for improvement could focus on specific characteristic population and high-risk PN individuals by nomogram assessment.

[Relationship between physical activity and cognition function among people aged 55 and above in 4 provinces of China].

OBJECTIVE: To analyze the relationship between different intensity of physical activity(PA) duration and cognitive function. METHODS: The 2018 Community-based Cohort Study on Nervous System Diseases used multi-stage stratified cluster randomization sampling method to select study participants. A total of 5571 participants aged 55 years and above from four provinces in China with complete information on demographic characteristics and PA and cognitive function were included in the final analysis. Basic information and PA data were collected by questionnaire. The Montreal cognitive assessment(MoCA) score method was adopted to evaluate the cognitive function. Light physical activity(LPA) duration and moderate-to-vigorous physical activity(MVPA) duration were calculated. Multivariate Logistic regression and Multiple linear regressions were used to analyze the relationship between different intensity of PA duration and the risk of mild cognitive impairment(MCI) and MoCA total score. RESULTS: The median(P25, P75) of LPA and MVPA were 7. 0(0. 0, 16. 3) and 7. 3(0. 0, 14. 0) hours per week in the non-MCI group among 5571 participants aged 55 years and above in four provinces of China in 2018. In the MCI group, the median duration were 9. 3(0. 0, 17. 5) and 7. 0(0. 0, 11. 7) hours per week. The Logistic analysis showed that the OR of MCI was 0. 63(95%CI 0. 49-0. 82, P<0. 05) for the elderly with 3. 6-7. 0 hours of MVPA per week, compared to the elderly without MVPA. The OR of MCI was 1. 26(95%CI 0. 94-1. 67, P>0. 05) for the elderly with 3. 6-7. 0 hours of LPA per week compared to the elderly without LPA. Multiple linear regression analysis showed that compared to the elderly without MVPA, the total MoCA score increased with LPA duration increased as the duration was less than 10. 5 hours per week. The MoCA score decreased with LPA duration increased as duration was between 10. 5 and 21. 0 hours per week. CONCLUSION: MVPA duration increment was associated with decreased prevalence of MCI and increased cognitive function in the elderly in four provinces of China. LPA duration should be maintained at an appropriate level in order to reduce the incidence of MCI and increased cognitive function in the elderly.