The Introduction of Low-Dose CT Imaging and Lung Cancer Overdiagnosis in Chinese Women

Wang, Mengyan; Lin, Shangqun; He, Na; Yang, Chen; Zhang, Ruoxin; Liu, Xing; Suo, Chen; Lin, Tao; Chen, Haiquan; Xu, Wanghong

doi:10.1016/j.chest.2022.08.2207

Cited by 21 publications

(9 citation statements)

References 40 publications

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“…In fact, such study of incidence rates is especially desirable and timely in East Asia in view of the recent observations that in East Asia, there exists a nearly simultaneous decrease in smoking rates, extensive introduction of low-dose computed tomography (LDCT) lung cancer screening, and a shift in lung cancer stage at diagnosis. 15 , 16 , 17 , 18 , 19 , 20 These studies pointed out overdiagnosis due to LDCT lung cancer screening, 15 , 18 an increase in incidence rates in females, 18 and the relevance of the subtype ADC in this context. 18 These findings reinforce the importance of the study of sex differences in lung ADC incidence and overdiagnosis by smoking status.…”

Section: Introductionmentioning

confidence: 97%

“… 15 , 16 , 17 , 18 , 19 , 20 These studies pointed out overdiagnosis due to LDCT lung cancer screening, 15 , 18 an increase in incidence rates in females, 18 and the relevance of the subtype ADC in this context. 18 These findings reinforce the importance of the study of sex differences in lung ADC incidence and overdiagnosis by smoking status. To address some of these problems, we examined age-, sex-, and stage-specific lung ADC incidence rates by smoking status (ever or never smoker) in Taiwan.…”

Section: Introductionmentioning

confidence: 97%

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Incidence of Lung Adenocarcinoma by Age, Sex, and Smoking Status in Taiwan

Chien,

Jiang,

Tsai

et al. 2023

JAMA Netw Open

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ImportanceKnowing whether the effects of smoking and other risk factors with lung adenocarcinoma (ADC) incidence varies by sex would provide information on lung cancer prevention strategies.ObjectiveTo evaluate whether women in Taiwan have higher age- and tumor stage–specific lung ADC incidence rates than men irrespective of smoking status (ie, ever smoker or never smoker).Design, Setting, and ParticipantsThis population-based cohort study used data sets synthesized from the Taiwan Cancer Registry (TCR) from 1979 to 2019; the TCR Long Form (TCRLF) from 2011 to 2019, which provides individual-level smoking and tumor stage information; the Taiwan Cause of Death Database (TCOD) from 1985 to 2019; the National Health Insurance Research Database (NHIRD) from 2000 to 2020; the Monthly Bulletin of Interior Statistics (MBIS) from 2011 to 2019; the National Health Interview Survey from 2001, 2005, 2009, 2013, and 2017; and Taiwan Biobank data from 2008 to 2021. Included patients were aged 40 to 84 years and had any invasive lung cancer from January 1, 2011, to December 31, 2019.ExposureSmoking status.Main Outcomes and MeasuresThe main outcomes were age-specific female-to-male incidence rate ratios (IRRs) of lung ADC by smoking status and tumor stage. Linked data from the TCR, TCOD, NHIRD, Taiwan National Health Interview Survey, and MBIS were used to estimate the age- and sex-specific numbers of cancer-free individuals at midyears from 2011 to 2019 by smoking status. Using the TCR and TCRLF, age-, sex-, tumor stage–, and diagnosis year–specific numbers of patients with lung ADC from 2011 to 2019 by smoking status were estimated.ResultsA total of 61 285 patients (32 599 women [53.2%]) aged 40 to 84 years (mean [SD] age, 64.66 [10.79] years) in the Taiwanese population of approximately 23 million were diagnosed with invasive lung ADC as their first lifetime cancer between 2011 and 2019. Among smokers, men had higher tobacco use by almost all examined metrics, including nearly twice the mean (SD) number of pack-years smoked (eg, 7.87 [8.30] for men aged 30-34 years vs 4.38 [5.27] for women aged 30-34 years). For 5-year age bands between 40 and 84 years, incidence of lung ADC was significantly higher among females than males for nearly all age groups irrespective of tumor stage and smoking status (eg, for the age group 70-74 years, the female-to-male IRR for late-stage lung ADC among never smokers was 1.38 [95% CI, 1.30-1.50]).Conclusions and RelevanceIn this cohort study, women had higher age- and stage-specific lung ADC incidence rates than men in Taiwan for both never and ever smokers, suggesting the possibility of differential exposures between sexes to risk factors other than smoking and the potential modification of ADC risk factors by sex. Further work is needed to determine whether this pattern replicates in other populations, discover the causes of lung ADC, and put preventive measures in place.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

Incidence of Lung Adenocarcinoma by Age, Sex, and Smoking Status in Taiwan

Chien,

Jiang,

Tsai

et al. 2023

JAMA Netw Open

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“…Additionally, Shanghai also reports the highest increase in young females and an increasing trend in incidence mainly in early-stage cancer and lung adenocarcinoma. However, the incidence of late-stage cases did not decrease, suggesting that LDCT examinations may lead to the overdiagnosis of lung cancer in females [ 28 ]. A study in Taiwan also concluded that in mostly non-smoking Asian females, LDCT screening was associated with lung cancer overdiagnosis [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term trends of lung cancer incidence and survival in southeastern China, 2011–2020: a population-based study

Zhou,

Xiang,

Lin

et al. 2024

BMC Pulm Med

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Background Lung cancer is the primary cause of cancer-related deaths in China. This study analysed the incidence and survival trends of lung cancer from 2011 to 2020 in Fujian Province, southeast of China, and provided basis for formulating prevention and treatment strategies. Methods The population-based cancer data was used to analyse the incidence of lung cancer between 2011 and 2020, which were stratified by sex, age and histology. The change of incidence trend was analysed using Joinpoint regression. The relative survival of lung cancer with onset in 2011–2014, 2015–2017 and 2018–2020 were calculated using the cohort, complete and period methods, respectively. Results There were 23,043 patients diagnosed with lung cancer in seven registries between 2011 and 2020, with an age-standardized incidence rate (ASIR) of 37.7/100,000. The males ASIR increased from 51.1/100,000 to 60.5/100,000 with an annual percentage change (APC) of 1.5%. However, females ASIR increased faster than males, with an APC of 5.7% in 2011–2017 and 21.0% in 2017–2020. Compared with 2011, the average onset age of males and females in 2020 was 1.5 years and 5.9 years earlier, respectively. Moreover, the proportion of adenocarcinoma has increased, while squamous cell carcinoma and small cell carcinoma have decreased over the past decade. The 5-year relative survival of lung cancer increased from 13.8 to 23.7%, with a greater average increase in females than males (8.7% and 2.6%). The 5-year relative survival of adenocarcinoma, squamous cell carcinoma and small cell carcinoma reached 47.1%, 18.3% and 6.9% in 2018–2020, respectively. Conclusions The incidence of lung cancer in Fujian Province is on the rise, with a significant rise in adenocarcinoma, a younger age of onset and the possibility of overdiagnosis. Thus, Fujian Province should strengthen the prevention and control of lung cancer, giving more attention to the prevention and treatment of lung cancer in females and young populations.

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“…One of the direct detecting cytosensor was reported by H. Xu, et.al, this method is known as macrocyclic supramolecular detection method involving host and guest complex formation. As shown in Figure 1a, psulfonated calix [8]arene (SCX8) served as a host, and folic acid (FA) molecule served as a guest which has been formed a complex and detected the cancer cells. This biosensor was composed of black phosphorene (BPene)/ polydopamine (PDA)/SCX8.FA (Figure 1b) [44].…”

Section: Direct Detection Of Ctcsmentioning

confidence: 99%

“…Normal cells are surrounded the cancer cells in the body and these cells resemble each other, so it is challenging to diagnose and cure cancer. A few of the common procedures are used to diagnose cancers include Magnetic Resonance Imaging (MRI) [6,7], Computed Tomography (CT) [8][9][10], Positron Emission Tomography (PET) [9][10][11], flow cytometry [12,13], and biopsy [14][15][16][17][18][19][20]. Liquid biopsy, a non-invasive cancer cell detection method, calls for the collection of bodily fluids with little to no sample preparation [21].…”

Section: Introductionmentioning

confidence: 99%

Advanced electrocatalytic materials based biosensors for cancer cell detection – A review

et al. 2023

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Herein, we have highlighted the latest developments on biosensors for cancer cell detection. Electrochemical (EC) biosensors offer several advantages such as high sensitivity, selectivity, rapid analysis, portability, low‐cost, etc. Generally, biosensors could be classified into other basic categories such as immunosensors, aptasensors, cytosensors, electrochemiluminescence (ECL), and photo‐electrochemical (PEC) sensors. The significance of the EC biosensors is that they could detect several biomolecules in human body including cholesterol, glucose, lactate, uric acid, DNA, blood ketones, hemoglobin, and others. Recently, various EC biosensors have been developed by using electrocatalytic materials such as silver sulfide (Ag2S), black phosphene (BPene), hexagonal carbon nitrogen tube (HCNT), carbon dots (CDs)/cobalt oxy‐hydroxide (CoOOH), cuprous oxide (Cu2O), polymer dots (PDs), manganese oxide (MnO2), graphene derivatives, and gold nanoparticles (Au‐NPs). In some cases, these newly developed biosensors could be able to detect cancer cells with a limit of detection (LOD) of 1 cell/mL. In addition, many remaining challenges have to be addressed and validated by testing more real samples and confirm that these EC biosensors are more accurate and reliable to measure cancer cells in the blood and salivary samples.

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The Introduction of Low-Dose CT Imaging and Lung Cancer Overdiagnosis in Chinese Women

Cited by 21 publications

References 40 publications

Incidence of Lung Adenocarcinoma by Age, Sex, and Smoking Status in Taiwan

Incidence of Lung Adenocarcinoma by Age, Sex, and Smoking Status in Taiwan

Long-term trends of lung cancer incidence and survival in southeastern China, 2011–2020: a population-based study

Advanced electrocatalytic materials based biosensors for cancer cell detection – A review

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