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Screening baseline characteristics of early lung cancer on low-dose computed tomography with computer-aided detection in a Chinese population
Institution:1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark;2. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA;3. Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark;1. Programa de Hematologia-Oncologia Pediátrica - PHOP, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil;2. Divisão de Vigilância e Análise de Situação, Coordenação de Prevenção e Vigilância, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil;3. Secretaria Estadual de Saúde da Paraíba, Registro de Câncer de Base Populacional de João Pessoa, Brazil;4. Secretaria Municipal de Saúde de Recife, Registro de Câncer de Base Populacional de Recife, Brazil;5. Secretaria de Saúde do Estado do Ceará, Registro de Câncer de Base Populacional de Fortaleza, Brazil;6. Secretaria Estadual de Saúde de Minas Gerais, Superintendência de Epidemiologia, Registro de Câncer de Base Populacional de Belo Horizonte, Brazil;7. Hospital de Câncer de Barretos, Fundação Pio XII, Registro de Câncer de Base Populacional de Barretos, Brazil;8. Coordenação Estadual de Atenção Oncológica, Secretaria Estadual de Saúde do Pará, Registro de Câncer de Base Populacional de Belém, Brazil;9. Secretaria Municipal de Saúde de Curitiba, Registro de Câncer de Base Populacional de Curitiba, Brazil;10. Secretaria Estadual de Saúde, Hospital Gov. João Alves Filho, Registro de Câncer de Base Populacional de Aracaju, Brazil;11. Fundação Centro de Controle de Oncologia, Registro de Câncer de Base Populacional de Manaus, Brazil;12. Associação de Combate ao Câncer de Goiás, Registro de Câncer de Base Populacional de Goiânia, Brazil;13. Secretaria Estadual de Saúde do Espírito Santo, Registro de Câncer de Base Populacional de Espírito Santo, Brazil;14. Faculdade de Saúde Pública da Universidade de São Paulo, Registro de Câncer de Base Populacional de São Paulo, Brazil;15. Secretaria Municipal de Saúde de Porto Alegre, Registro de Câncer de Base Populacional de Porto Alegre, Brazil;p. Secretaria de Estado de Saúde do Mato Grosso, Superintendência de Vigilância em Saúde, Registro de Câncer de Base Populacional de Cuiabá, Brazil;q. Fundação Hospital Amaral Carvalho, Registro de Câncer de Base Populacional de Jahu, Brazil;1. Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China;2. Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing China;3. State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing 210023, China;4. State Key Laboratory of Bioelectronics, Southeast University, Nanjing, China;1. Department of Surgery, Division of Urology, Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;2. Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA;3. Surgery Section, Durham VA Health Care System, Durham, NC, USA;4. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA;5. Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA;6. Institute for Translational Epidemiology, and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA;7. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA;1. Universidad de Las Palmas de Gran Canaria, Calle Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Spain;2. Dermatology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain;3. Research Unit, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain;1. East Tallinn Central Hospital, Oncology Center, Ravi St 18, 10138 Tallinn, Estonia;2. National Institute for Health Development, Department of Epidemiology and Biostatistics, Hiiu St 42, 11619 Tallinn, Estonia;3. West Tallinn Central Hospital, Womens’ Clinic, Paldiski St 68, 10617 Tallinn, Estonia;4. Tartu University Hospital, Haematology and Oncology Clinic, L. Puusepa St 1A, 50406 Tartu, Estonia
Abstract:ObjectivesThis study investigated appropriate baseline characteristics for screening a Chinese population at high risk of early lung cancer, assisted by low-dose computed tomography (LDCT) with computer-aided detection (CAD). Included is a discussion of the viability of using LDCT in the screening guideline and optimizing the guideline.MethodsIn 2014, 1016 individuals from Sichuan Province were enrolled who satisfied the criteria for high risk according to the 2013 National Comprehensive Cancer Network (NCCN) Guidelines for Non-Small Cell Lung Cancer. From 2014 to 2018, each subject was followed using LDCT with CAD, and pathologically confirmed lung cancers and baseline nodule characteristics (size and density) were recorded. Positive risk was considered a non-calcified solid or part-solid nodule on LDCT with diameter ≥5 mm and ground-glass nodule ≥8 mm, as newly recommended by the China National Lung Cancer Screening Guideline.ResultsFrom 2014–2018, 13 cases of lung cancer were detected; 5 of these were early stage (38.5%). According to the NCCN criteria, 54 women were included and one of these (1.8%) developed lung cancer. The prevalence of lung cancer was 0.7% at baseline. For the entire population (excluding subjects with a tumor mass at baseline, n = 4), the rate of positivity was 20.4% at baseline; applying the Chinese criteria, the false positive rate was 19.5% (197/1012).ConclusionsFurther studies are warranted to establish appropriate eligible criteria and management strategies for Chinese populations.
Keywords:Lung cancer  LDCT  CAD  Guideline
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