Participation and Yield of a Lung Cancer Screening Program in Hebei, China

ObjectiveLung cancer screening has been widely conducted in Western countries. However, population-based lung cancer screening programs in Hebei in China are sparse. Our study aimed to assess the participation rate and detection rate of positive nodules and lung cancer in Hebei province.MethodIn total, 228 891 eligible participants aged 40–74 years were enrolled in the Cancer Screening Program in Hebei from 2013 to 2019. A total of 54 846 participants were evaluated as the lung cancer high-risk population by a risk score system which basically followed the Harvard Risk Index and was adjusted for the characteristics of the Chinese population. Then this high-risk population was recommended for low-dose computed tomography (LDCT) screening. And all participants attended annual passive follow-up, and the active follow-up interval was based on radiologist’s suggestion. All participants were followed-up until December 31, 2020. The overall, group-specific participation rates were calculated, and its associated factors were analyzed by a multivariable logistic regression model. Participation rates and detection of positive nodules and lung cancer were reported.ResultsThe overall participation rate was 52.69%, where 28 899 participants undertook LDCT screening as recommended. The multivariable logistic regression model demonstrated that a high level of education, having disease history, and occupational exposure were found to be associated with the participation in LDCT screening. The median follow-up time was 3.56 person-years. Overall, the positive identification of lung nodules and suspected lung cancer were 12.73% and 1.46% through LDCT screening. After the native and passive follow-up, 257 lung cancer cases were diagnosed by lung cancer screening, and the detection rate of lung cancer was 0.89% in the screening group. And its incidence density was 298.72 per 100,000. Positive lung nodule rate and detection rate were increased with age.ConclusionOur study identified personal and epidemiological factors that could affect the participation rate. Our findings could provide the guideline for precise prevention and control of lung cancer in the future.

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Community-based lung cancer screening program: A five-year comprehensive review.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e13080 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e13080-e13080

Author(s):

Ari Hakimian ◽

Axel Joob ◽

Jennifer Aversano ◽

Michael Vercillo ◽

Michael Oconnor ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Screening Program ◽

Lung Cancer Screening ◽

Smoking History ◽

Community Based ◽

Cancer Screening Program ◽

History Of ◽

Lung Cancer Screening Program

e13080 Background: Low-dose chest CT for lung cancer screening has been shown to have a significant impact on the early diagnosis of lung cancer. Initial trials have shown an approximate 20% decrease in overall lung cancer mortality (NLST, 2011). This study incorporates all patients who were evaluated by the Center for Thoracic Disease in a community-based lung cancer screening program from 2013 to 2018. Over the course of the study, thoracic surgeons have evaluated these patients with subsequent interval-based scans to monitor the progression of suspicious nodules. Methods: Eligibility criteria for the program included patients within the age range of 55-80, with a > 30 pack year smoking history, and that were current smokers or quit tobacco less than 15 years ago. Individuals between 50-55 years old were also included if they had > 20 pack year smoking history and at least one additional lung cancer risk factor. All patients included in this analysis completed an initial lung cancer screening consultation and recommended follow-up evaluations with thoracic surgeons from March 2013 to December 2018. All patients with suggestive abnormalities were discussed at a multidisciplinary conference prior to embarking on any invasive procedures. Patient data was collected on REDCap. Descriptive statistics for all continuous (mean ± SD) and categorical [N (%)] variables were calculated on patients. Results: 470 patients were included in the final analysis. The majority of the patients were males (56.4%), mean age was 64 years old (range: 50-81), and 55.3% were current smokers. The average smoking history was 42.3 pack years. 223 (47.6%) patients had a family history of cancer and 70 (14.5%) patients had a personal history of cancer. 25 patients (5.3%) had a diagnosis of primary lung cancer, among whom, 16 patients (64%) had early stage lung cancer (stage 1 and stage 2), 5 patients (20%) had stage 3, and 4 patients (16%) had stage 4 lung cancer. The cancer distribution included 17 adenocarcinomas (68%), 3 squamous cell carcinomas (12%), 3 small cell cancers (12%), 1 large cell cancer (4%) and 1 carcinoid tumor (4%). Conclusions: This study has demonstrated the value of enrolling patients in a community-based lung cancer screening program. Our results have reiterated the prevalence of discovering early staged lung cancer in high risk patients. This comprehensive five-year review indicates the importance of physician coordinated follow-up and evaluation in lung cancer screening patients.

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Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up

BMC Cancer ◽

10.1186/s12885-020-06923-0 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Michael Lake ◽

Christine S. Shusted ◽

Hee-Soon Juon ◽

Russell K. McIntire ◽

Charnita Zeigler-Johnson ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Screening Program ◽

Lung Cancer Screening ◽

Cancer Screening Program ◽

Black Patients ◽

Lung Cancer Screening Program

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The Impact of Smoking and Screening Results on Adherence to Follow-up in an Academic Multisite Lung Cancer Screening Program

Annals of the American Thoracic Society ◽

10.1513/annalsats.202006-631rl ◽

2020 ◽

Author(s):

Matthew Triplette ◽

J. Hank Thayer ◽

Erin K. Kross ◽

Allison M. Cole ◽

David Wenger ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Screening Program ◽

Lung Cancer Screening ◽

Cancer Screening Program ◽

Lung Cancer Screening Program ◽

The Impact

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The Challenge of Achieving Appropriate Follow-Up in a Community Lung Cancer Screening Program

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a4482 ◽

2019 ◽

Author(s):

M.A. Bernstein ◽

S. Gold ◽

M. Ronk ◽

L. Drysdale ◽

J. Krinsley ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Screening Program ◽

Lung Cancer Screening ◽

Cancer Screening Program ◽

Lung Cancer Screening Program

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Performance of Lung Cancer Screening With Low-Dose Computed Tomography in Gejiu, Yunnan: A Prospective, Population-Based, Screening Cohort Study

JCO Global Oncology ◽

10.1200/go.20.19000 ◽

2020 ◽

Vol 6 (Supplement_1) ◽

pp. 24-24

Author(s):

Meng-Na Wei ◽

Zheng Su ◽

Jian-Ning Wang ◽

Xiao-Yun Yu ◽

Qing-Hua Zhou ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

High Risk ◽

Detection Rate ◽

Screening Program ◽

Rural China ◽

Lung Cancer Screening ◽

Cancer Screening Program ◽

Lung Cancer Screening Program ◽

Low Dose Computed Tomography

PURPOSE Low-dose computed tomography (LDCT) screening has been recommended for individuals with high lung cancer risk, but the performance of lung cancer screening with LDCT in China is uncertain. This study aims to evaluate the performance of LDCT lung cancer screening in the Chinese setting. METHODS From June 2014 through December 2014, a prospective cohort of patients to undergo lung cancer screening with LDCT was established in Gejiu, Yunnan Province, using one screening center of the Lung Cancer Screening Program in Rural China. Participants received baseline screening and 4 rounds of annual screening with LDCT until June 2019. The participation rate, detection rate, early detection rate, and clinical characteristics of lung cancer were reported. RESULTS Of participants, 2,006 had complete baseline screening results with a compliance rate of 98.4%. Of these, 1,411 were high-risk and 558 were non–high-risk individuals. During this period, 40 lung cancer cases were confirmed, and of them, 35 were screen detected, 4 were postscreening, and 1 was an interval case. The positive rate of baseline and annual screening was 9.7% and 9.0%, respectively, whereas the lung cancer detection rate was 0.4% and 0.6%, respectively. The proportion of early lung cancer increased from 37.5% in T0 to 75.0% in T4. Adenocarcinoma was the most common histologic subtype. Lung cancer incidence according to the criteria of the Lung Cancer Screening Program in Rural China and the National Lung Cancer Screening Trial was 513.31 per 100,000 person-years and 877.41 per 100,000 person-years, respectively CONCLUSION The lung cancer screening program with LDCT was a successful performance in Gejiu, Yunnan; however, additional studies are warranted to refine the high-risk population who will benefit most from LDCT screening and reduce the high false-positive results.

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