Low-Dose Spiral Computed Tomography Screening Aids in Reduction of Lung Cancer Mortality

One-off low-dose spiral computed tomography (LDCT) screening demonstrated accuracy in detecting positive nodules, an important means toward reducing lung cancer mortality

“To improve the [positive nodule] management protocols for a specific population, studies should include participants at high risk for [lung cancer] within the [positive nodule] population,” wrote lead author Dr Haifan Xiao, The Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, China, and coauthors, noting, “this may increase the rate of early diagnosis and reduce [lung cancer] mortality among [positive nodule] patients.”

The prospective, community-based, cohort study included 14901 candidates at high risk for lung cancer from 2012 to 2018. Patients were divided in positive nodule and non-positive nodule groups. The efficacy of positive nodule detection was evaluated based on incidence, mortality, and all-cause mortality, with subgroup analyses of characteristic variables to evaluate the potential association between positive nodule and lung cancer risk.

Positive nodules were detected in 1193 (8%) patients. Among those patients, after a median follow-up of 6.1 years, 193 (1.3%) were diagnosed with lung cancer, 94 (8%) of which were in the positive nodule group. Lung cancer incidence, mortality, and all-cause mortality were all significantly higher in the postive nodule group compared with the non-positive nodule group (adjusted hazard ratios [HR]: 10.6 [7.91 to 14.2], 7.97 [5.2 to 12.2], and 1.94 [1.51 to 2.5], respectively).

“Our results suggest an improvement in population-specific management of PN patients to improve the early diagnosis rate of [lung cancer] after PN detection by one-off LDCT screening, as this may contribute significantly to [lung cancer] control by accurately managing the PNs,” concluded Dr Xiao and colleagues.

Source:

Xiao H, Shi Z, Zou Y, et al. One-off low-dose CT screening of positive nodules in lung cancer: A prospective community-based cohort study. Lung Cancer. 2023;177:1-10. doi:10.1016/j.lungcan.2023.01.005