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. 2022 Nov 22:12:991485.
doi: 10.3389/fonc.2022.991485. eCollection 2022.

Secondary preventing effect of lung cancer in non-high-risk population: A retrospective investigation of opportunistic screening with low-dose computed tomography in Wuhan

Zhiqiang Zhou  1 , Chun Qiu  2 , Shangkun Liu  3 , Shaofang Wang  4 , Danning Wang  1 , Hui Xu  1
Affiliations

Secondary preventing effect of lung cancer in non-high-risk population: A retrospective investigation of opportunistic screening with low-dose computed tomography in Wuhan

Zhiqiang Zhou et al. Front Oncol. .

Abstract

Background: Given the mortality benefit of low-dose computed tomography (LDCT) screening on high-risk populations, the retrospective investigation intended to identify the benefits of LDCT on lung cancer screening among the general demographic cohorts.

Methods: We used an opportunistic screening with LDCT implemented during the pandemic in Wuhan to study the impact on subsequent thoracic surgeries, especially surgeries for lung cancer. Patients who received LDCT from October 1, 2019, to July 31, 2020, in three Triple-A accredited hospitals in Wuhan were included in the study. Relative week volumes of both surgeries before and after the chest LDCT screening were compared pairwise. The counts of surgeries for pulmonary nodules or masses, and corresponding pathological results among different gender and age groups were also compared.

Result: The relative weekly volumes of thoracic surgery were significantly greater than those of stomach surgery after the opportunistic screening with LDCT. They were 33% (95% CI, 0.20-0.46; p<0. 001) higher than those of stomach surgery. For every 1,000 chest LDCT scans conducted in a given week, on average, 3.52(95% CI,0.56-6.49, p =0.03) thoracic surgeries were performed in the following week. After the implementation of opportunistic screening with LDCT, there was a higher percentage of young females with pulmonary nodule or mass (64.4% vs. 45.8%, p = 0.032). The fraction of lung cancer surgery in the treatment period was significantly greater than that in the control period (74.09% vs. 68.79%, p=0.007). There was a higher percentage of stage I lung cancer surgery in young and mid-age females than in the senior age group (64% vs. 53%, p= 0.05).

Interpretation: Opportunistic screening with LDCT can advance the early diagnosis window of lung cancer in non-high-risk populations, especially young women who are easy to be ignored.

Keywords: chest LDCT; lung cancer; opportunistic screening; thoracic surgery; young female.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow Chart. The period from October 2019 to January 2020 was defined as the control period, and the period from April 2020 to July 2020 was defined as the treatment period. LDCT, low-dose computed tomography.
Figure 2
Figure 2
The Comparison of Changes in Relative Weekly Volumes of Thoracic Surgery with Stomach Surgery in the Control and Treatment Periods. Relative weekly volumes were the ratio of the weekly counts and the average weekly counts of surgery in 2019. The relative weekly volumes of thoracic surgery and stomach surgery were plotted respectively for the control and treatment periods. By the end of Treatment period (July 2020), the relative weekly volumes of thoracic surgery reached 150% of the weekly average of 2019.
Figure 3
Figure 3
Comparison of the Fractions of Weekly Performed Lung Cancer Surgery in the Control and Treatment Periods. Percentages were the mean fractions of lung cancer surgery performed weekly. The mean fraction of lung cancer surgery in the treatment period was significantly greater than that of the control period (p=0.007).
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