Oncotarget

Clinical Research Papers:

Necessity of organized low-dose computed tomography screening for lung cancer: From epidemiologic comparisons between China and the Western nations

Hong-Feng Gou, Yang Liu, Tian-Xia Yang, Cheng Zhou and Xin-Zu Chen _

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Oncotarget. 2017; 8:1788-1795. https://doi.org/10.18632/oncotarget.12400

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Abstract

Hong-Feng Gou1, Yang Liu2,*, Tian-Xia Yang3, Cheng Zhou4,5,6 and Xin-Zu Chen7

1 Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China

2 West China School of Public Health, Sichuan University, Chengdu, China

3 Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China

4 Translational Radiation Oncology, National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany

5 Heidelberg Ion Therapy Center (HIT), Department of Radiation Oncology, University Heidelberg Medical School, Heidelberg, Germany

6 German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany

7 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

* These authors have contributed equally as a co-first author

Correspondence to:

Xin-Zu Chen, email:

Keywords: lung cancer; screening; low-dose computed tomography; epidemiology; mortality

Received: March 26, 2016 Accepted: September 13, 2016 Published: October 01, 2016

Abstract

Objectives: To compare the proportion of stage I lung cancer and population mortality in China to those in U.S. and Europe where lung cancer screening by low-dose computed tomography (LDCT) has been already well practiced.

Methods: The proportions of stage I lung cancer in LDCT screening population in U.S. and Europe were retrieved from NLST and NELSON trials. The general proportion of stage I lung cancer in China was retrieved from a rapid meta-analysis, based on a literature search in the China National Knowledge Infrastructure database. The lung cancer mortality and prevalence of China, U.S. and Europe was retrieved from Globocan 2012 fact sheet. Mortality-to-prevalence ratio (MPR) was applied to compare the population survival outcome of lung cancer.

Results: The estimated proportion of stage I lung cancer in China is merely 20.8% among hospital-based cross-sectional population, with relative ratios (RRs) being 2.40 (95% CI 2.18–2.65) and 2.98 (95% CI 2.62–3.38) compared by LDCT-screening population in U.S. and Europe trials, respectively. MPR of lung cancer is as high as 58.9% in China, with RRs being 0.46 (95% CI 0.31–0.67) and 0.58 (95% CI 0.39–0.85) compared by U.S. and Europe, respectively.

Conclusions: By the epidemiological inference, the LDCT mass screening might be associated with increasing stage I lung cancer and therefore improving population survival outcome. How to translate the experiences of lung cancer screening by LDCT from developed counties to China in a cost-effective manner needs to be further investigated.


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