Screening baseline characteristics of early lung cancer on low-dose computed tomography with computer-aided detection in a Chinese population

Liu, Yuanyuan; Luo, Hong-Bin; Qing, Haomiao; Wang, Xiaodong; Ren, Jing; Xu, Gelin; Hu, Shibei; He, Chao; Zhou, Peng

doi:10.1016/j.canep.2019.101567

Cited by 12 publications

(5 citation statements)

References 29 publications

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“…Applying the NCCN protocol, 0.6% participants needed referral. This finding is similar to a study performed in Shanghai (12) but lower than a study in Sichuan, China (13). According to the report of lung cancer screening in a general population in Shanghai, 0.6% of included participants required referral to a pulmonologist (diameter ≥15 mm) (12).…”

Section: Discussionsupporting

confidence: 82%

Comparison of National Comprehensive Cancer Network and European Position Statement protocols for nodule management in low-dose computed tomography lung cancer screening in a general Chinese population

Du¹,

Li²,

Dorrius³

et al. 2021

J Thorac Dis

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Background: Low-dose computed tomography (LDCT) lung cancer screening often refers individuals to unnecessary examinations. This study aims to compare the European Position Statement (EUPS) and National Comprehensive Cancer Network (NCCN) protocols in management of participants at baseline screening round. Methods: LDCT lung cancer screening was prospectively performed in a Chinese asymptomatic population aged 40-74 years. A total of 1,000 consecutive baseline LDCT scans were read twice independently. All screen-detected lung nodules by the first reader were included. The first reader manually measured the diameter of lung nodules (NCCN protocol), and the second reader semi-automatically measured the volume and diameter (EUPS volume and diameter protocols). The protocols were used to classify the participants into three management groups: next screening round, short-term repeat LDCT scan and referral to a pulmonologist. Groups were compared using Wilcoxon test for paired samples. Number of lung cancers by protocols was provided. Results: Of the 1,000 participants (61.4±6.7 years old), 168 lung nodules in 124 participants were visually detected and manually measured in the first reading, and re-measured semi-automatically. Applying the NCCN protocol, EUPS volume and diameter protocol, the proportion of referrals among all participants was 0.6%, 1.9%, and 1.4%, respectively. The proportion of short-term repeat scans was 4.5%, 9.7% and 4.5%, respectively. Among the 10 lung cancer patients, one would have been diagnosed earlier if the EUPS volume protocol would have been followed. Conclusions: In a first round screening in a Chinese general population, the lower threshold for referral in the EUPS protocol as compared to the NCCN protocol, leads to more referrals to a pulmonologist, with the potential of earlier cancer diagnosis. The EUPS volume protocol recommends fewer participants to shortterm repeat LDCT scan than the EUPS diameter protocol. Follow-up studies should show the impact of both protocols on (interval) cancer diagnosis.

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Section: Discussionsupporting

confidence: 82%

Comparison of National Comprehensive Cancer Network and European Position Statement protocols for nodule management in low-dose computed tomography lung cancer screening in a general Chinese population

Du¹,

Li²,

Dorrius³

et al. 2021

J Thorac Dis

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“…The literature search yielded 16 LDCT screening studies for lung cancer [12,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40], and all were included in the meta-analysis. Of those, 14 were conducted in mainland China, 9 were conducted in a general population, and 7 were conducted in high-risk populations (definitions of high-risk varied; Table S3).…”

Section: Characteristics Of Studies In the Meta-analysismentioning

confidence: 99%

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

Huang

et al. 2021

European Journal of Radiology

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“…With the progress of higher spatial resolution of CT scanners combined with more advanced postprocessing software, the prevalence of lung nodules in lung cancer screening may vary from 21 to 86% depending on acquisition protocol, the population included, and guidelines used during 2006–2018 [ 6 ]. Although the majority of detected lung nodules are benign, lung cancer rate in participants with non-calcified pulmonary baseline nodules ranges from 2 to 11% [ 7 , 8 ]. About 3–4% of the participants with a non-calcified nodule at baseline will develop lung cancer within the following 2–5 years [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Association between visual emphysema and lung nodules on low-dose CT scan in a Chinese Lung Cancer Screening Program (Nelcin-B3)

et al. 2022

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Objectives This study aimed to evaluate the association between visual emphysema and the presence of lung nodules, and Lung-RADS category with low-dose CT (LDCT). Methods Baseline LDCT scans of 1162 participants from a lung cancer screening study (Nelcin-B3) performed in a Chinese general population were included. The presence, subtypes, and severity of emphysema (at least trace) were visually assessed by one radiologist. The presence, size, and classification of non-calcified lung nodules (≥ 30 mm3) and Lung-RADS category were independently assessed by another two radiologists. Multivariable logistic regression and stratified analyses were performed to estimate the association between emphysema and lung nodules, Lung-RADS category, after adjusting for age, sex, BMI, smoking status, pack-years, and passive smoking. Results Emphysema and lung nodules were observed in 674 (58.0%) and 424 (36.5%) participants, respectively. Participants with emphysema had a 71% increased risk of having lung nodules (adjusted odds ratios, aOR: 1.71, 95% CI: 1.26–2.31) and 70% increased risk of positive Lung-RADS category (aOR: 1.70, 95% CI: 1.09–2.66) than those without emphysema. Participants with paraseptal emphysema (n = 47, 4.0%) were at a higher risk for lung nodules than those with centrilobular emphysema (CLE) (aOR: 2.43, 95% CI: 1.32–4.50 and aOR: 1.60, 95% CI: 1.23–2.09, respectively). Only CLE was associated with positive Lung-RADS category (p = 0.02). CLE severity was related to a higher risk of lung nodules (ranges aOR: 1.44–2.61, overall p < 0.01). Conclusion In a Chinese general population, visual emphysema based on LDCT is independently related to the presence of lung nodules (≥ 30 mm3) and specifically CLE subtype is related to positive Lung-RADS category. The risk of lung nodules increases with CLE severity. Key Points • Participants with emphysema had an increased risk of having lung nodules, especially smokers. • Participants with PSE were at a higher risk for lung nodules than those with CLE, but nodules in participants with CLE had a higher risk of positive Lung-RADS category. • The risk of lung nodules increases with CLE severity.

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Screening baseline characteristics of early lung cancer on low-dose computed tomography with computer-aided detection in a Chinese population

Cited by 12 publications

References 29 publications

Comparison of National Comprehensive Cancer Network and European Position Statement protocols for nodule management in low-dose computed tomography lung cancer screening in a general Chinese population

Comparison of National Comprehensive Cancer Network and European Position Statement protocols for nodule management in low-dose computed tomography lung cancer screening in a general Chinese population

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

Association between visual emphysema and lung nodules on low-dose CT scan in a Chinese Lung Cancer Screening Program (Nelcin-B3)

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