LDCT screening results among eligible and ineligible screening candidates in preventive health check-ups population: a real world study in West China.

To compare the LDCT screening results between eligible and ineligible screening candidates in preventive health check-ups population. Using a real-world LDCT screening results among people who took yearly health check-up in health management center of West China Hospital between 2006 and 2017. Objects were classified according to the China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2018 version) eligibility criteria. Descriptive analysis were performed between eligible and ineligible screening candidates. The proportion of ineligible screening candidates was 64.13% (10,259), and among them there were 4005 (39.04%) subjects with positive screenings, 80 cases had a surgical lung biopsy. Pathology results from lung biopsy revealed 154 cancers (true-positive) and 26 benign results (false-positive), the surgical false-positive biopsy rate was 4.17%, and ineligible group (7.69%) was higher than eligible group (2.47%), P < 0.05. Further, in ineligible screening candidates, the proportion of current smokers was higher among males compared to females (53.85% vs. 4.88%, P < 0.05). Of the 69 lung cancer patients detected in ineligible screening candidates, lung adenocarcinoma accounts for a high proportion of lung cancers both in male (75.00%) and female (85.00%). The proportion of ineligible screening candidates and the surgical false-positive biopsy rate in ineligible candidates were both high in health check-ups population.

Analysis of screening outcomes and factors influencing compliance among community-based lung cancer high-risk population in Nanchang, China, 2018-2020.

Objective: To investigate the screening results and compliance of low-dose computed tomography (LDCT) screening among the high-risk lung cancer populations in Jiangxi Province from 2018 to 2020, and to explore the related influencing factors of compliance. Methods: From November 2018 to October 2020, permanent residents in Nanchang City were selected and their demographic data and lung cancer risk factor data were collected to screen high-risk groups, and LDCT screening was performed on high-risk groups with diagnostic reports by 2 chief physicians. Descriptive analysis method was used to analyze the basic information of screening, screening results and screening compliance. χ2 and logistic regression test were used to conduct single and multi-factor analysis of screening compliance. Results: A total of 26,588 people participated in this screening, of which 34.4% (n=9,139) were at high risk of lung cancer, 3,773 participants were completed LDCT screening, and the screening compliance rate was 41.3%. Screening results showed that 389 participants were positive for suspected pulmonary tumor or lung nodules, the screening positive rate of 10.3%. The logistic multivariable results of screening compliance showed that the compliance was better in males, those who quit smoking, those with chronic respiratory diseases and family history of cancer, and those who have primary education, those with a history of occupational harmful exposure had a poor compliance. Conclusion: Compliance with lung cancer screening in Jiangxi Province, China still needs to be improved, and gender, education level, harmful occupational exposure, smoking, chronic respiratory diseases, and family history of tumors cancer play an important role on screening compliance.

Application effect of low-dose spiral CT on pulmonary nodules and its diagnostic value for benign and malignant nodules.

OBJECTIVE: This study was designed to determine the application effect of low-dose computed tomography (LDCT) on detecting pulmonary nodules (PNs) and its diagnostic value for benign and malignant pulmonary nodules. METHODS: Data of 432 patients with PNs admitted to Julu County Hospital between March 2018 and June 2021 in were collected and analysed retrospectively. All patients underwent LDCT and conventional-dose spiral computed tomography (CT). The detection rate and image characteristics of the two methods were compared, and the image quality and radiation dose of the two diagnostic methods were also compared. RESULTS: No significant difference was found between LDCT and conventional-dose spiral CT in the detection rate of lung cancer (P>0.05). The area under the curve of conventional-dose CT was 0.932, with a specificity and sensitivity of 93.87% and 92.45%, and the area under the curve of LDCT was 0.902, with a specificity and sensitivity of 90.80% and 89.62%. The radiation dose consumed during LDCT was greatly less than that consumed by conventional-dose CT (P<0.05). Additionally, the two methods were not different in CT image quality and superior vena cava artifact (P>0.05). No notable difference was found between LDCT and conventional-dose CT in terms of the diagnosis rate of PNs in vascular aggregation sign, pleural indentation sign, lobulation sign and spiculation sign. CONCLUSION: LDCT can clearly show the typical images of early lung cancer, with less effective radiation dose, and can thus contribute to a high detection rate, so it is worth popularizing.

Influencing factors of LDCT recommendation by physicians in Sichuan Province, China.

The study aimed to investigate the influencing factors of physicians in recommending low-dose computed tomography (LDCT) for lung cancer screening to high-risk groups. A total of 1767 participants with good knowledge of LDCT were included in a cross-sectional study. Data about physicians' demographics, perception of barriers on LDCT screening, medical conditions for practicing medicine and the behavior of recommending LDCT were collected by a questionnaire. Physicians who care about the transportation convenience of patients were less likely to recommend LDCT (OR 0.568, 95% CI (0.423 to 0.763), p < 0.05). The physicians who considered LDCT expensive, recommended LDCT less than others (OR 0.308, 95% CI (0.186 to 0.510), p < 0.05). The false positive rate of LDCT can decrease the possibility of physicians' recommending (OR 0.542, 95% CI (0.387 to 0.758), p < 0.05). The physicians in oncology department and health management center were more likely to recommend LDCT (OR 2.282, 95% CI (1.557 to 3.345); OR 2.476, 95% CI (1.618 to 3.791)). The convenience of transportation, the price, and the\ false positive rate may be the main concerns among physicians on recommending LDCT to high-risk groups. The influencing factors of physicians' recommending on LDCT was various. Information technology, government support in price and self-improvement of LDCT should be gathered together to break the barriers on physicians' recommending on LDCT.

Diagnosis Value of Tumor-associated Auto-antibodies Combined with Low-dose Spiral Computed Tomography in Early Lung Cancer Screening / 肿瘤防治研究

Objective To investigate the application value of serum auto-antibody detection combined with low-dose spiral computed tomography (LDCT) in early lung cancer screening. Methods From 12568 medical examination crowd (7453 males and 5115 females), 1324 people with high-risk cases of lung cancer in our medical examination center were divided randomly into three groups (LDCT, serum auto-antibody, and serum auto-antibody combined with LDCT groups). All people in this research were screened by chest X-ray. Follow-up was conducted for one year, and the positive screening and diagnosis rates of early lung cancer screening were compared between these groups of high-risk people with lung cancer. Results The positive screening and diagnostic rates of high-risk lung cancer in the serum auto-antibody combined with LDCT group was significantly higher those that in other two groups (P < 0.001). The specificity and sensitivity of serum auto-antibody combined with LDCT group were 89.1% and 88.4%, respectively; the area under the ROC curve was 0.863. Conclusion Serum auto-antibody detection combined with low-dose spiral CT can significantly improve the positive screening rate of lung cancer in high-risk populations, providing a strong theoretical support for lung cancer screening pathway.

Analysis of risk assessment and screening results of lung cancer among residents in 3 cities of Shanxi Province from 2014 to 2018 / 肿瘤研究与临床

Objective:To investigate the risk of lung cancer and screening results of residents in 3 cities of Shanxi Province from 2014 to 2018.Methods:Cluster random sampling method was used to select permanent residents from 3 cities (Taiyuan, Jincheng and Yangquan) in Shanxi Province from January 2014 to December 2018 for lung cancer risk assessment. People at high risk of lung cancer were screened by low-dose spiral CT. The screening results were analyzed and the influencing factors of lung cancer occurrence were analyzed by unconditional logistic regression.Results:184 539 people were included in the survey, and 36 790 people (19.94%) were at high risk of lung cancer. The detection rate of high-risk of lung cancer in men was higher than that in women [29.76% (25 690/184 539) vs. 11.30% (1 100/184 539), χ2 = 10.44, P = 0.001]. A total of 12 660 people (34.41%) at high risk of lung cancer participated in clinical screening, and 3 038 people (24.00%) were positive in clinical screening for lung cancer. There were no statistical differences in the positive rate of clinical screening among people at high risk of lung cancer with different gender, nationality, education, marital status, occupation, history of harmful substance exposure, coal burning, clean heating, indoor oil fumes, and history of pulmonary tuberculosis (all P > 0.05). There were statistical differences in the positive rate of clinical screening among people at high risk of lung cancer with different age, smoking, drinking, drinking tea, physical exercise, exposure time of second-hand smoke, living environment air pollution, history of emphysema, history of pneumoconiosis, family history of lung cancer, mental depression, and history of trauma (all P < 0.05). Logistic regression analysis showed that age ≥ 50 years old, smoking, exposure to second-hand smoke for 1-14 years, living environment air pollution, history of emphysema, family history of lung cancer, and mental depression were the risk factors for positive clinical screening in people at high risk of lung cancer (all P < 0.05), and physical exercise was the protective factor for positive clinical screening in people at high risk of lung cancer ( P < 0.05). Conclusions:The screening rate of people at high risk of lung cancer in 3 cities of Shanxi Province needs to be improved. The detection rate of intrapulmonary nodules in people at high risk of lung cancer is mainly affected by age, smoking, exposure time of second-hand smoke, family history of lung cancer, history of emphysema and other factors.

Comparison of the diagnostic value of spiral CT scans at different doses for COPD / 中国现代医生

Objective To compare the diagnostic value of spiral CT scans at different doses for COPD, and to provide reference for the clinical selection of diagnostic method of COPD. Methods A total of 120 patients with a preliminary diagnosis of COPD were enrolled. The clinical symptoms, exposure history of risk factors, and family history were recorded in detail. All patients were given pulmonary function tests. The patients were randomly divided into two groups, the conventional-dose spiral CT group and the low-dose spiral CT group, and were given conventional-dose spiral CT scan and low-dose spiral CT scan, respectively. The results were read and graded by two separated radiologists, and the differences in imaging quality, radiation dose and diagnostic accuracy between the two groups were compared, and the diagnostic value of spiral CT scans at different doses for COPD was evaluated. Results There was no significant difference in the excellent rate of the images and the accuracy of the diagnosis results between the two groups (P>0.05). The radiation dose of the low-dose spiral CT was significantly lower than that of the conventional-dose spiral CT, and the difference was statistically significant (P<0.05). Conclusion The accuracy of low-dose spiral CT scan is comparable to that of conventional-dose spiral CT, and the low radiation dose has little damage to the human body, which has good reference value for the diagnosis of COPD. The excellent rates of conventional dose spiral CT and lowdose spiral CT are similar, but the image quality of the former is better.

Value of low-dose spiral CT scanning in high-risk population screening of lung cancer / 重庆医学

Objective To investigate the application value of low-dose spiral CT(LDCT) scanning in high-risk population screening of lung cancer.Methods A total of 1 071 cases of LDCT lung scanning(observation group) and 350 cases of conventional dose CT lung scanning dose(control group) from October 2015 to May 2017 were performed the comparison on mean irradiation dose,lesion occurrence rate and diagnostic accuracy.Results The computed tomographic dose index(CTDI) in the observation group was(0.74±0.28)mSv;the excellent image quality rate was 95.42 ％;the positive detection rate was 43.60 ％ (467/1 071);13cases(1.21 ％)were confirmed as lung cancer by pathology.The average CTDI in the control group was(14.46 ± 4.21)mSv;the excellent image quality rate was 98.85 ％;the positive detection rate was 45.1 ％ (158/350);5 cases(1.43％) were confirmed as lung cancer by pathology.The average radiation dose and image quality showed statistically significant difference between the two groups (P＜0.05),and the positive detection rate and diagnostic rate of lung cancer had no statistical difference between the two groups (P＞0.05).Conclusion LDCT scan has good image quality,can significantly reduce the subject's irradiation dose without affecting the detection of lung lesions and lung cancer occurrence rate.

Analysis of lung cancer screening results of 9265 urban residents in Urumqi from year 2014 to 2016 / 实用肿瘤学杂志

Objective The objectives of this study were to analyze the results of lung cancer screening from 9265 urban residents in Urumqi from year 2014 to 2016,and to evaluate the significance of early diagnosis and treatment of cancer for the lung cancer prevention.Methods A total of 31,177 people with high risk of lung cancer were assessed by cancer risk questionnaire surveyed from 40 to 69 years old residents in Urumqi.High-risk groups were assigned to low-dose spiral CT scan in Affiliated Tumor Hospital of Xinjiang Medical University.Results 9,265 people were scanned with low dose spiral CT and overall completion rate was 29.7％.There had 11.9％ detection rate in 1,005 people who were scanned positive pulmonary nodules.The detection rate was 31.9％ for 2,955 people who were scanned solid nodules(＜5 mm) and 2.5％ for 236 people who had the non solid nodules(＜ 8 mm).After screening,14 patients were diagnosed by pathology and the detection rate was 0.2％.The emphysema,pulnonary cysts,pulmonary bullae and other related lung disease were detected in 4,095 people and the detection rate was 44.2％.Conclusion The lung health status of Urumqi residents was found by a wide range of lung cancer screening,and the awareness of lung cancer prevention and control was greatly improved.It provided the basis for the establishment of effective prevention and treatment system,which was helpful to improve the early diagnosis and treatment rate of lung cancer.

Shanghai community-based practice of early lung cancer screening with low-dose spiral computed tomography / 中国癌症杂志

Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.