Community-based lung cancer screening by low-dose computed tomography in China: First round results and a meta-analysis

Li, Yanju; Du, Yihui; Huang, Yubei; Zhao, Yingru; Sidorenkov, Grigory; Vonder, Marleen; Cui, Xiaonan; Fan, Shuxuan; Dorrius, Monique D.; Vliegenthart, Rozemarijn; Groen, Harry J.M.; Liu, Shi-yuan; Song, Fengju; Chen, Kexin; Bock, Geertruida H. de; Ye, Zhaoxiang

doi:10.1016/j.ejrad.2021.109988

Cited by 11 publications

(8 citation statements)

References 62 publications

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“…The detection rate of lung cancer in this project was 2.2% (99/4,536), which was higher than the previous results of other screening programmes in China, such as CanSPUC ( 14 ) 0.35% (78/22,260), Shanghai ( 19 ) 1.23% (178/14,506), and Chinese community population lung cancer screening ( 15 ) 0.5% (30/5,523), and its meta-analysis of lung cancer detection rate in a high-risk Chinese population was 0.6% [95% confidence interval (CI): 0.3–0.9%]. This is similar to the results of the Second Brazilian Early Lung Cancer Screening Trial (BRELT2) ( 23 ) 2.1% (73/3,470) and Balata et al ’s ( 3 ) meta-analysis of the 5 results of UK screening 2.2% (250/11,148).…”

Section: Discussioncontrasting

confidence: 69%

“…Interestingly, the adherence rate of the National Lung Screening Trial (NLST) ( 1 ) was also as high as 95%, although without clear reason. Moreover, the adherence figure in the research of the Cancer Screening Programme in Urban China (CanSPUC) by Guo et al ( 14 ) was only 40.2% (22,260/55,428) and that in the study on Chinese community population lung cancer screening by Li et al ( 15 ) was 69.6% (5,523/7,936). Lam et al ( 16 ) and Wang et al ( 17 ) suggested that compliance might be related to anxiety about being diagnosed with lung cancer and a lack of an individualized screening programme.…”

Section: Discussionmentioning

confidence: 96%

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Evaluation of a lung cancer screening programme attracting a cohort to actively participate in screening: Honghe Lung Cancer Medical Center Programme

Li¹,

Zheng²,

Peng³

et al. 2022

Transl Cancer Res

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Background: A lung cancer screening project was conducted by attracting active participation to evaluate its feasibility and effectiveness in areas with poor basic medical education.Methods: This project entailed a prospective, single-arm study which was conducted by means of delivering a lecture on lung cancer at the Honghe Lung Cancer Medical Center to attract public attention and attendance from 28 November 2020 to 21 December 2021. A questionnaire comprising 7 high-risk factors was completed by participants to identify high-risk individuals for further chest low-dose computed tomography examination. Non calcified nodules with a diameter ≥5 mm were deemed positive nodules. The positive nodules were discussed by a multidisciplinary team and treatment suggestions were given. Finally, we analyzed participant information, examination adherence, lung cancer detection rate, and staging.Results: A total of 6,121 individuals were attracted to the project, and 5,925 (96.8%) agreed to participate.Of these, 5,889 (99.4%) completed the survey, with 4,627 (78.6%) in the high-risk group and 1,262 (21.4%) in the non-high-risk group. The proportion of males in the high-risk group was higher than that in the nonhigh-risk group, and the difference was statistically significant among those aged 40-49 years, 50-59, years and 60-69 years; P<0.01. In the high-risk population, 4,536 (98.0%) of participants adhered to examination, among whom 2,007 (44.2%) with positive nodules, 1,220 (26.9%) with negative nodules, and 1,309 (28.9%) without nodules showed statistical differences in age; P<0.01. The detection rate of lung cancer was 2.2% (99/4,536); 94.0% (93/99) of whom were stage 0-I patients.Conclusions: A health lecture-based approach to improving public participation in regions with poor health education is likely to be effective in promoting the early detection of lung cancer.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 96%

Evaluation of a lung cancer screening programme attracting a cohort to actively participate in screening: Honghe Lung Cancer Medical Center Programme

Li¹,

Zheng²,

Peng³

et al. 2022

Transl Cancer Res

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“…The superiority of LDCT screening over non-screening has been known to be reflected in the relatively high distribution of patients with early-stage LC ( 6 – 9 ). In this study, data of the distribution of patients with localized-, regional- and distant-LC in the screening and non-screening cohorts were derived from a latest comprehensive meta-analysis, which pooled and analyzed all published results of the canSPUC programme and the ruraCSP programme as of February 2021 ( 30 ).…”

Section: Methodsmentioning

confidence: 99%

Lung cancer screening with low-dose computed tomography: National expenditures and cost-effectiveness

Zeng

Zhou²,

Luo³

et al. 2022

Front. Public Health

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ObjectiveTo compare the cost-effectiveness of undertaking low-dose computed tomography (LDCT) screening for early detection of lung cancer (LC) with different frequencies within the healthcare system of China, and estimate the additional national healthcare expenditure and five-year LC mortality associated with different screening frequencies.Material and methodsA Markov model was established using national LC epidemiological data from the Chinese Center for Disease Control and Prevention, demographic data from the Chinese Statistical Yearbook, and cost and effectiveness data mainly from the Cancer Screening Program in China. The model included thirty sex-specific screening strategies, which were classified by initial screening age (30, 35, 40, 45, and 50), and screening intervals (intervals at single time point, 1, 2, 5, 10, and 20 years). The main model outputs were incremental cost-effectiveness ratios (ICERs), additional national healthcare expenditure and five-year LC mortality.ResultsThe ICERs for LDCT screening strategies vs. non-screening strategy ranged from $16,086 per quality-adjusted life-year (QALY) to $3,675,491 per QALY in the male cohort, and from $36,624 per QALY to $5,943,556 per QALY in the female cohort. The annual increment national healthcare expenditures related to LDCT screening were varied from $0.25 to $13.39 billion, with the lower cost in the cohort with older screening ages and lower screening frequencies. More frequent screening with LDCT was associated with a greater reduction in LC death: an annual LDCT screening was linked to an estimated reduction in five-year LC death by 27.27–29.07%, while a one-off screening was linked to a reduction by 5.56–5.83%.ConclusionUnder a willingness-to-pay (WTP) threshold of three times the Chinese gross domestic product (GDP) per capita (US $37,654), annual screening with an initiating age at 50 was most cost-effective in both male and female cohorts. By taking into account both the national healthcare expenditures and the effect of LDCT screening, our study results support undertaking LDCT screening annually from 50 years old in general populations.

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“…By contrast, EV long RNAs (evlRNAs), including messenger RNAs (mRNAs), circular RNAs (circRNAs), and long noncoding RNAs (lncRNAs), are abundant in human blood EVs and have been demonstrated to show strong potential in cancer diagnoses, such as hepatocellular cancer (HCC), pancreatic ductal adenocarcinoma, and prostate cancer 19–21 . Notably, EV‐associated long RNAs have been rarely investigated in lung cancers, if at all, While they may be particularly useful for early‐stage lung adenocarcinoma (LUAD) with <2 cm diameter tumors, which account for the majority of lung cancers detected by screening, 2 especially for the high‐risk Chinese population 10,22–24 . To address this overlooked potential, in the current study, we evaluate the efficacy of evlRNA sequencing for diagnosing LUAD with a tumor size <2 cm.…”

Section: Introductionmentioning

confidence: 99%

“…[19][20][21] Notably, EV-associated long RNAs have been rarely investigated in lung cancers, if at all, While they may be particularly useful for early-stage lung adenocarcinoma (LUAD) with <2 cm diameter tumors, which account for the majority of lung cancers detected by screening, 2 especially for the high-risk Chinese population. 10,[22][23][24] To address this overlooked potential, in the current study, we evaluate the efficacy of evlRNA sequencing for diagnosing LUAD with a tumor size <2 cm.…”

Section: Introductionmentioning

confidence: 99%

Extracellular vesicle long RNA markers of early‐stage lung adenocarcinoma

Zhang

Liu

Zhang

et al. 2022

Intl Journal of Cancer

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Lung cancer screening by low‐dose computed tomography (LDCT) can improve mortality rates among high‐risk individuals, especially adenocarcinoma cases with characteristically poor prognosis, although high false‐positive rates have limited its clinical application. The objective of our study was to identify biomarkers for early‐stage lung adenocarcinoma (ie, tumor diameter <2 cm) through extracellular vesicle long RNA (evlRNA) sequencing. High throughput evlRNA sequencing and support vector machine (SVM) identification of candidate diagnostic marker transcripts were performed using serum samples obtained before lung surgery. A total of 145 upregulated and 363 downregulated differential genes (P value <.05, fold change >1.5) were identified between lung adenocarcinoma (LUAD) patients and benign controls. An SVM model based on a 23‐gene signature could distinguish EV samples of LUAD patients from those of control subjects with 86.49% sensitivity, 95.00% specificity and 92.31% accuracy in the training set and 93.75% sensitivity, 85.71% specificity and 88.24% accuracy in the validation set. A 17‐gene signature was then identified that could distinguish AIS patient samples from those of MIA/IAD patients with 93.33% sensitivity, 98.00% specificity, and 96.25% accuracy in the trainingset and 83.33% sensitivity, 96.55% specificity, and 94.29% accuracy in the validation set. EvlRNAs in serum show considerable diagnostic value for screening LUAD patients with tumor sizes <2 cm in conjunction with LDCT, potentially reducing false positive rates while improving mortality rates.

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Community-based lung cancer screening by low-dose computed tomography in China: First round results and a meta-analysis

Cited by 11 publications

References 62 publications

Evaluation of a lung cancer screening programme attracting a cohort to actively participate in screening: Honghe Lung Cancer Medical Center Programme

Evaluation of a lung cancer screening programme attracting a cohort to actively participate in screening: Honghe Lung Cancer Medical Center Programme

Lung cancer screening with low-dose computed tomography: National expenditures and cost-effectiveness

Extracellular vesicle long RNA markers of early‐stage lung adenocarcinoma

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