LBA48 Community-based mass screening with low-dose CT for lung cancer in Guangzhou

Abstract

This study aimed to investigate an approach for lung cancer (LC) screening in the general population and develop a risk prediction model to improve risk assessment. This project is a community-based mass screening with LDCT for the early detection of LC. Participants were enrolled and screened from 2015 to 2021. Eligible subjects were between 40 and 74 years of age among the residents from four communities in Guangzhou, while exclusion criteria were persons diagnosed with LC within the past 5 years. A questionnaire including detailed demographic data and health conditions was used. Binary logistic regression analysis was used to screen potential risk factors. A multivariate model was built based on the participant characteristics combined with carcinoembryonic antigen (CEA) at a cutoff of 3.9. Model discrimination was evaluated by the area under the curve (AUC). 11,708 participants were screened, comprising 5,452 males and 6,256 females with a median age of 59 (IQR, 51-65) years. 189 (1.6%) LCs were diagnosed, among which 162 (85.7%) cases were in stage 0-I. Only 37 (19.6%) and 105 (55.6%) of diagnosed cases met the criteria per NCCN and Chinese screening guidelines, respectively. We found seven independent risk/protective factors for LC through multivariate adjustment (Table). Using these variables combined with CEA, the model presented an AUC of 0.71 (95%CI, 0.67-0.75), which was significantly higher than that of guidelines in NCCN (0.52, 95%CI 0.50-0.55) and China (0.62 95%CI 0.58-0.67), respectively. Stratified analysis by smoking and stages showed that the AUCs were higher among smokers (0.77, 95%CI 0.71-0.83) and stage I to IV LC (0.74, 95%CI 0.70-0.78, excluding MIA) than in non-smokers (0.69, 95%CI 0.64-0.74) and preinvasive diseases (AIS and MIA, 0.64, 95%CI 0.57-0.72), respectively.Table: LBA48FactorOR (95% CI)P valuePersonal cancer history6.03 (4.02-9.02)＜0.001Exposure to silicon dioxide5.22 (1.13-24.1)0.034Age50-59 vs. 40-491.50 (0.82-2.76)0.18860-74 vs. 40-492.27 (1.26-4.09)0.006Food allergy2.58 (1.33-5.02)0.005History of asthma2.32 (1.31-4.13)0.004Family history of cancerLung cancer1.58 (1.04-2.40)0.033Other cancer1.12 (0.77-1.64)0.549Allergy to temperature change0.46 (0.28-0.77)0.003 Open table in a new tab Mass screening with LDCT can identify early-stage LC in Guangzhou, and a risk prediction model based on participant characteristics combined with CEA improves LC risk assessment.