<p>Landscape on CT screening for lung cancer in Asia</p>

Abstract

Lung cancer remains the leading cause of cancer incidence and mortality worldwide. Approximately 60% of the world’s new cases of lung cancer and deaths from it are expected in Asia in 2018. Currently, lung cancer screening using low-dose computed tomography (LDCT) is recommended for heavy smokers in North America, Europe and some countries in Asia. Tobacco smoking being the major risk factor for lung cancer, but in Asia, lung cancer in never-smokers (LCINS) is also a concern. This paper reviews on lung cancer incidence, mortality, etiology, smoking in Asia, and systematic reviews on LDCT lung cancer screening studies, including ongoing projects and recommendation on lung cancer screening in Asia. Some of the earliest studies of LDCT lung cancer screening worldwide were in Asia. Many countries in Asia have developed LDCT screening studies in various high-risk participants. Currently, there are several ongoing large-scale lung cancer screening trials to evaluate the efficacy of LDCT screening for never-smokers and light smokers, as well as heavy smokers, and to evaluate the feasibility of population-based LDCT lung cancer screening.

Differences in detection patterns, characteristics, and outcomes of central and peripheral lung cancers in low-dose computed tomography screening

“…This study, on a large hospital-based cohort of individuals who underwent LDCT for lung cancer screening in South Korea, assessed the characteristics and outcomes of centrally-located lung cancer in comparison with peripherally-located lung cancer with a focus on screendetection status. The cohort of asymptomatic participants who voluntarily underwent LDCT screening enabled the evaluation of a large number of never-smokers and relatively young individuals, and reflects the real-world state of LDCT screening in East Asia, where it is widely applied to these populations (15,31). In accordance to a prior study evaluating LDCT screening in the Asian population, our data also revealed better outcomes in diagnosed stage and mortality in the screen-detected cancer group (32).…”

“…However, many other regions do not yet have criteria for such screening, and emerging data suggest that expending the screening criteria would be beneficial (7,8). In East Asia, where the burden of lung cancer among never-smokers is relatively high and increasing (9)(10)(11), LDCT screening has shown promising results of mortality benefits and stage shifts in several realworld cohort studies including never-smokers (12,13), and is widely applied for both never-and ever-smokers as well as for relatively young individuals (14,15).…”

Lung Cancer in India

“…8 In an ongoing study (NCT03909620) evaluating the role of LDCT for lung cancer screening at a tertiary care center in India (n ¼ 221), 33.5% of the subjects had a positive result after the first round of screening and 1.8% were diagnosed as having lung cancer (unpublished data), which is comparable with data from other countries in the region. 9 Encouragingly, the presence of radiological sequelae of tuberculosis was not associated with a positive LDCT scan in this study.…”

Awareness and Use of Complementary and Alternative Medicine in Korean Lung Cancer Patients

“…Third, as described in Table 1 , our patients consisted of more of limited-stage SCLC and were treated with all types of modalities compared to the previous population-based study 17 . We contend that the expanded concept of lung cancer screening may have resulted in increased numbers of lung cancer patients detected at earlier stages or with treatable disease 39 . Also, drastic improvements in treatments such as immunotherapy in the last decade may have increased the number of patients indicated for treatment 40 .…”