TY - JOUR
T1 - Current lung cancer screening guidelines may miss high-risk population
T2 - a real-world study
AU - Ji, Guiyi
AU - Bao, Ting
AU - Li, Zhenzhen
AU - Tang, Huairong
AU - Liu, Dan
AU - Yang, Ping
AU - Li, Weimin
AU - Huang, Yan
N1 - Funding Information:
This manuscript was produced with the financial and other support of by the Research Fund for the National Key R&D Program of China (Grant No. 2017YFC0907501 and Grant No. 2017YFC0907504), National Natural Science Foundation of China (Nos. 81871890, 91859203 to W Li), and Sichuan International/Hong Kong, Macao and Taiwan Science and technology innovation cooperation project: molecular imaging research on targeted treatment of lung cancer (2018hh0161), Post-Doctor Research Project, West China Hospital, Sichuan University (2019HXBH085), Investigator-Initiated Clinicaltrial, West China Hospital, Sichuan University (HXCR20001). The funding agencies were not involved in the design and conduct of the study, nor in the collection, management, analysis, and interpretation of the data. It was not involved in the writing of the manuscript.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Despite much research published on lung cancer screening, China has had no large-scale study on the missed diagnosis of lung cancer in a health examination population. We therefore did a real-world study using the current lung cancer screening guidelines to a health examination population in China to determine the proportion of lung cancer cases that have been missed. Methods: A real-world cohort study of screening, with the use of low-dose computed tomography, was conducted among people who took yearly health checkup in health management center of West China Hospital between 2006 and 2017. We respectively used current guidelines including lung cancer screening guidelines of the U.S. Preventive Services Task Force (USPSTF) and expert consensus on low dose spiral CT lung cancer screening in China. Results: In a total of 15,996 participants with health examination who completed the baseline screening, 6779 (42.4%) subjects had at least one positive finding, and 142 (2.1%) cases of lung cancer were screened positive. The false positive rate was 97.9%. Of 142 lung cancer cases detected in our study, only 9.2% met the lung cancer screening guidelines proposed by the USPSTF, and 24.4% met that of China. The rates of missed diagnosis were as high as 90.8 and 75.6% respectively. In addition, we did an in-depth analysis by gender. We found that among male patients with lung cancer, the proportion of smokers was 75%, and the proportion of young people under 50 was 23.2%. Among female patients with lung cancer, the proportion of smokers was only 5.8%, and the proportion of young people under 50 was up to 33.3%. Conclusions: The rate of missed diagnosis was as high as 90.8% applying the current lung cancer screening guidelines to the health examination population in China. Further study to determine screening guidelines for targeted populations, is warranted.
AB - Background: Despite much research published on lung cancer screening, China has had no large-scale study on the missed diagnosis of lung cancer in a health examination population. We therefore did a real-world study using the current lung cancer screening guidelines to a health examination population in China to determine the proportion of lung cancer cases that have been missed. Methods: A real-world cohort study of screening, with the use of low-dose computed tomography, was conducted among people who took yearly health checkup in health management center of West China Hospital between 2006 and 2017. We respectively used current guidelines including lung cancer screening guidelines of the U.S. Preventive Services Task Force (USPSTF) and expert consensus on low dose spiral CT lung cancer screening in China. Results: In a total of 15,996 participants with health examination who completed the baseline screening, 6779 (42.4%) subjects had at least one positive finding, and 142 (2.1%) cases of lung cancer were screened positive. The false positive rate was 97.9%. Of 142 lung cancer cases detected in our study, only 9.2% met the lung cancer screening guidelines proposed by the USPSTF, and 24.4% met that of China. The rates of missed diagnosis were as high as 90.8 and 75.6% respectively. In addition, we did an in-depth analysis by gender. We found that among male patients with lung cancer, the proportion of smokers was 75%, and the proportion of young people under 50 was 23.2%. Among female patients with lung cancer, the proportion of smokers was only 5.8%, and the proportion of young people under 50 was up to 33.3%. Conclusions: The rate of missed diagnosis was as high as 90.8% applying the current lung cancer screening guidelines to the health examination population in China. Further study to determine screening guidelines for targeted populations, is warranted.
KW - Health examination population
KW - High-risk population
KW - LDCT
KW - Lung cancer
KW - Real-world study
KW - Screening
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U2 - 10.1186/s12885-020-07750-z
DO - 10.1186/s12885-020-07750-z
M3 - Article
C2 - 33430831
AN - SCOPUS:85099186157
SN - 1471-2407
VL - 21
JO - BMC cancer
JF - BMC cancer
IS - 1
M1 - 50
ER -