Evaluation of a Low-Dose Computed Tomography Lung Cancer Screening Program in Henan, China

Abstract

IMPORTANCE Lung cancer screening has been widely implemented in Europe and the US. However, there is little evidence on participation and diagnostic yields in population-based lung cancer screening in China. OBJECTIVE To assess the participation rate and detection rate of lung cancer in a population-based screening program and the factors associated with participation. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the Cancer Screening Program in Urban China from October 2013 to October 2019, with follow-up until March 10, 2020. The program is conducted at centers in 8 cities in Henan Province, China. Eligible participants were aged 40 to 74 and were evaluated for a high risk for lung cancer using an established risk score system. MAIN OUTCOMES AND MEASURES Overall and group-specific participation rates by common factors, such as age, sex, and educational level, were calculated. Differences in participation rates between those groups were compared. The diagnostic yield of both screening and nonscreening groups was calculated. RESULTS The study recruited 282 377 eligible participants and included 55 428 with high risk for lung cancer; the mean (SD) age was 55.3 (8.1) years, and 34 966 participants (63.1%) were men. A total of 22 260 participants underwent LDCT (participation rate, 40.16%; 95% CI, 39.82%-40.50%). The multivariable logistic regression model showed that female sex (odds ratio [OR], 1.64; 95% CI,

A risk prediction model for selecting high-risk population for computed tomography lung cancer screening in China

“…Therefore, in the present study, with the focus on established risk factors for lung cancer routinely available in general cancer screening settings, we aimed to develop and internally validated a risk prediction model for lung cancer. The details of the CanSPUC could be found in previously published articles [48]. Briefly, after obtaining signed written informed consent, all the participants completed a questionnaire that included demographic characteristics, lifestyle factors, items assessing general health and medical history, and family history of common disease.…”

Construction and Validation of a Lung Cancer Risk Prediction Model for Non-Smokers in China

“…The model was developed based on the Cancer Screening Program in Urban China (CanSPUC) ( 45 ). With the focus on established risk factors for lung cancer routinely available in general cancer screening settings, we aimed to develop and internally validated a risk prediction model for lung cancer in Chinese non-smokers.…”

Lung Cancer Screening: Evidence, Risks, and Opportunities for Implementation

“…This is an important observation since women may show a higher adherence to LCS, allegedly related to their decennial experience with breast cancer screening. The above-mentioned CanSPUC study showed 50 % adherence among women, compared to a significantly lower rate of 33 % among men [30].…”

“…Several factors were associated with the lower participation rate, including age range 70-74 years, male gender, lower education level, no family history of LC, and current smoking status. Furthermore, the participation rate was heterogeneous between different regions, which can be related to a longer distance to the screening site [30]. To overcome such a limitation, the Manchester Lung Health Check program (a pilot community-based study) used mobile CT scanners placed outside shopping centers, with the purpose of providing access to LCS for high-risk subjects from the most deprived areas of Manchester [31].…”