Association of cancer screening and residing in a coal-polluted East Asian region with overall survival of lung cancer patients: a retrospective cohort study

Yang, Runxiang; He, Ming; Wang, Dongmei; Ye, Rongrong; Lu, Liwei; Deng, Rouyu; Shah, Mohsin; Yeung, Sai‐Ching Jim

doi:10.1038/s41598-020-74082-0

Cited by 4 publications

(1 citation statement)

References 43 publications

(55 reference statements)

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“…We know that air pollution can lead to pernicious health effects on (( Taghizadeh-Hesary and Taghizadeh-Hesary, 2020 , Zeng et al, 2020 ), including heart attacks, strokes ( Shah et al, 2015 ), diabetes, lung cancer ( Guo et al, 2016 ; Yang et al, 2020 ), and high blood pressure ( Maomao et al, 2018 ). These have also been identified among the pre-existing medical conditions that raise the chances of death from COVID-19 infection ( Coccia, 2020 ; Cole et al, 2020 ; Conticini et al, 2020 ; Ogen, 2020 ; Petroni et al, 2020 ; Setti et al, 2020 ; Travaglio et al, 2020 ; Wang et al, 2020a , b ; Wu et al, 2020 ; Yao et al, 2020a , b).…”

Section: Introductionmentioning

confidence: 99%

The impacts of human migration and city lockdowns on specific air pollutants during the COVID-19 outbreak: A spatial perspective

Zeng

Bao

2021

Journal of Environmental Management

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The outbreak of COVID-19 continues to bring unprecedented shock to mankind's socioeconomic activities, and to the wider environment. China, as the early epicenter of the pandemic, locked down one-third of its cities in an attempt to prevent the rapid spread of the virus. Human migration patterns have subsequently been radically altered and many regions have seen perceived improvements in air quality during the lockdowns. This study empirically examines the relationship between human migration and air pollution and further evaluates the causal impacts of the lockdowns. A spatial econometric method and a spatial explicit counterfactual framework are employed in this study. The key findings are as follows: i) a considerable amount of variation in AQI, PM 10 , PM 2.5 , and NO 2 concentration can be explained by human migration but we fail to find suggestive evidence in the cases of SO 2 and CO; ii) the implementation of lockdown measures led to a significant reduction in AQI (18.1%), PM 2.5 (22.2%), NO 2 (20.5%), and PM 10 (10.7%), but has no meaningful impacts on SO 2, CO and O 3 levels; iii) further analysis indicates that the impacts of lockdown policies varied by control stringency and by regional heterogeneity. Our findings are of great importance for the Chinese government to create a stronger and more coherent framework in its efforts to tackle air pollution.

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Section: Introductionmentioning

confidence: 99%

The impacts of human migration and city lockdowns on specific air pollutants during the COVID-19 outbreak: A spatial perspective

Zeng

Bao

2021

Journal of Environmental Management

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Opportunistic Screening With Low-Dose Computed Tomography and Lung Cancer Mortality in China

Wang,

Qi,

Liu

et al. 2023

JAMA Netw Open

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ImportanceDespite the recommendations of lung cancer screening guidelines and the evidence supporting the effectiveness of population-based lung screening, a common barrier to effective lung cancer screening is that the participation rates of low-dose computed tomography (LDCT) screening among individuals with the highest risk are not large. There are limited data from clinical practice regarding whether opportunistic LDCT screening is associated with reduced lung-cancer mortality.ObjectiveTo evaluate whether opportunistic LDCT screening is associated with improved prognosis among adults with lung cancer in mainland China.Design, Setting, and ParticipantsThis cohort study included patients diagnosed with lung cancer at Weihai Municipal Hospital Healthcare Group, Weihai City, China, from 2016 to 2021. Data were analyzed from January 2022 to February 2023.ExposuresData collected included demographic indicators, tumor characteristics, comorbidities, blood indexes, and treatment information. Patients were classified into screened and nonscreened groups on the basis of whether or not their lung cancer diagnosis occurred through opportunistic screening.Main Outcomes and MeasuresFollow-up outcome indicators included lung cancer–specific mortality and all-cause mortality. Propensity score matching (PSM) was adopted to account for potential imbalanced factors between groups. The associations between LDCT screening and outcomes were analyzed using Cox regression models based on the matched data. Propensity score regression adjustment and inverse probability treatment weighting were used for sensitivity analysis.ResultsA total of 5234 patients (mean [SD] baseline age, 61.8 [9.8] years; 2518 [48.1%] female) with complete opportunistic screening information were included in the analytical sample, with 2251 patients (42.91%) receiving their lung cancer diagnosis through opportunistic screening. After 1:1 PSM, 2788 patients (1394 in each group) were finally included. The baseline characteristics of the matched patients were balanced between groups. Opportunistic screening with LDCT was associated with a 49% lower risk of lung cancer death (HR, 0.51; 95% CI, 0.42-0.62) and 46% lower risk of all-cause death (HR, 0.54; 95% CI, 0.45-0.64).Conclusions and RelevanceIn this cohort study of patients with lung cancer, opportunistic lung cancer screening with LDCT was associated with lower lung cancer mortality and all-cause mortality. These findings suggest that opportunistic screening is an important supplement to population screening to improve prognosis of adults with lung cancer.

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Notice of Retraction and Replacement. Wang L, et al. Opportunistic Screening With Low-Dose Computed Tomography and Lung Cancer Mortality in China. JAMA Netw Open. 2023;6(12):e2347176

Xue

2024

JAMA Netw Open

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To the Editor On behalf of my coauthors, I write to explain errors in the Original Investigation, "Opportunistic Screening With Low-Dose Computed Tomography and Lung Cancer Mortality in China," 1 published in JAMA Network Open on December 12, 2023. In this study, we aimed to evaluate whether opportunistic low-dose computed tomography (LDCT) screening was associated with improved prognosis among 5234 adults with lung cancer in China. Our cohort included patients diagnosed with lung cancer who were classified into screened and nonscreened groups on the basis of whether or not their lung cancer diagnosis occurred through opportunistic screening. We reported that opportunistic screening with LDCT was significantly associated with a 49% lower risk of lung cancer death and 46% lower risk of all-cause death.After publication, readers posted comments with concerns about and symptomatic vs opportunistic screening 2 and potential lead time bias and length bias. 3 Following discussion with the JAMA Network Open editors, we conducted new analyses to address these concerns. To address the concern raised by Dr Hammer 2 about symptomatic vs opportunistic screening, we included the tumor characteristics into the propensity score model. To address concerns noted by Drs Stumpf and Rustagi's concerns 3 about lead time and length biases, we used methods proposed by Duffy et al. 4 Accordingly, to correct for lead time bias, we subtracted the expected lead time from the observed survival time for each patient in the screened group. We found large variation in reported lead times in the literature 5,6 ; therefore, we focused on an intermediate lead time of 210 days and comprehensively studied 150, 180, 240, and 270 days for sensitivity analysis. To correct for length bias, we first followed Duffy et al's method to calculate the unadjusted for confounding hazard ratio (HR) with and without correcting for length bias, which depends on the anticipated lead time bias. These results were used to compute a length bias correction factor, which was then applied to the HR estimates obtained after correction for confounding and lead time biases. By using this combined, ad hoc approach, all the 3 of biases were addressed in the final HR estimates. With these new analyses, we continue to find lower risk of lung cancer death and of all-cause death. However, we now find that opportunistic screening with LDCT was associated with a 34% lower risk of lung cancer death (HR, 0.66; 95% CI, 0.54-0.80) and 28% lower risk of all-cause death (HR, 0.72; 95% CI, 0.60-0.86).

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Association of cancer screening and residing in a coal-polluted East Asian region with overall survival of lung cancer patients: a retrospective cohort study

Cited by 4 publications

References 43 publications

The impacts of human migration and city lockdowns on specific air pollutants during the COVID-19 outbreak: A spatial perspective

The impacts of human migration and city lockdowns on specific air pollutants during the COVID-19 outbreak: A spatial perspective

Opportunistic Screening With Low-Dose Computed Tomography and Lung Cancer Mortality in China

Notice of Retraction and Replacement. Wang L, et al. Opportunistic Screening With Low-Dose Computed Tomography and Lung Cancer Mortality in China. JAMA Netw Open. 2023;6(12):e2347176

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