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

Abstract

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.