Results of low-dose computed tomography as a regular health examination among Chinese hospital employees
- PMID: 31987625
- DOI: 10.1016/j.jtcvs.2019.10.145
Results of low-dose computed tomography as a regular health examination among Chinese hospital employees
Abstract
Objective: Lung cancer is traditionally more prevalent in the elderly patients, men, and smokers. However, as low-dose computed tomography (LDCT) is increasingly popular, we hypothesized the disease spectrum might change.
Methods: LDCT was performed as a part of regular health examinations in 8392 of 15,686 employees from 6 hospitals in different regions of China in 2012 to 2018. Clinicopathologic characteristics, including age, sex, smoking status, radiologic features, tumor histology, and pathologic stage, were retrospectively analyzed.
Results: LDCT incidentally detected lung cancer (pathologically confirmed) in a total of 179 (2.1%) hospital employees. The lung cancer detection rate was significantly greater in female than male (2.5% vs 1.3%, P = .001) patients. There was also a greater detection rate among nonsmokers than smokers, although statistical significance was not reached (2.2% vs 1.4%, P = .092). The lung cancer detection rate was 1.0% in the "age ≤40 years" group, 2.6% in the "40 < age ≤55 years" group, and 2.9% in the "age >55 years" group (P < .001). Among the hospital employees with lung cancer, 171 (95.5%) presented as ground-glass opacity, 177 (98.9%) were lung adenocarcinoma, 170 (95.0%) were early stage 0/IA, and 177 (98.9%) received curative surgical resection as the initial treatment. After a median follow-up of 38 months, no disease recurrence or death was observed among these patients.
Conclusions: LDCT detected lung cancer in a significant proportion of young, female, and nonsmoking employees. The vast majority of these lung cancers were early stage, with extremely good prognosis.
Keywords: early-stage; female; low-dose computed tomography; lung cancer; nonsmokers; young.
Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
Comment in
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Commentary: Pay attention to low-risk populations for lung cancer, but cautiously interpret ground-glass nodules screened by low-dose computed tomography scan.J Thorac Cardiovasc Surg. 2020 Sep;160(3):833-834. doi: 10.1016/j.jtcvs.2019.10.204. Epub 2019 Nov 27. J Thorac Cardiovasc Surg. 2020. PMID: 31879166 No abstract available.
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Commentary: On-demand computed tomography screening for lung cancer-some surprising results.J Thorac Cardiovasc Surg. 2020 Sep;160(3):832-833. doi: 10.1016/j.jtcvs.2019.12.027. Epub 2019 Dec 24. J Thorac Cardiovasc Surg. 2020. PMID: 31926713 No abstract available.
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Commentary: The role of low-dose computed tomography for lung cancer screening among the nonsmoking Asian population.J Thorac Cardiovasc Surg. 2020 Sep;160(3):835-836. doi: 10.1016/j.jtcvs.2019.11.101. Epub 2019 Dec 12. J Thorac Cardiovasc Surg. 2020. PMID: 31959443 No abstract available.
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Commentary: The changing risk paradigm in lung cancer: Are we opening Pandora's box?J Thorac Cardiovasc Surg. 2020 Sep;160(3):836-837. doi: 10.1016/j.jtcvs.2019.12.037. Epub 2020 Jan 3. J Thorac Cardiovasc Surg. 2020. PMID: 32008763 No abstract available.
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