Abstract
BackgroundLung cancer has been the leading cause of cancer-related mortality worldwide among both men and women in recent years. There is an increase in the incidence of nonsmoking-related lung cancer in recent years. The purpose of the present study was to investigate multiple potential risk factors for nonsmoking-related lung cancer among Asian Ethnic Groups.MethodsWe used a propensity score-mated cohort analysis for this study. We retrospectively review the medical record of 1975 asymptomatic healthy subjects (40 ~ 80 years old) who voluntarily underwent low-dose chest CT from August 2013 to October 2014. Clinical information and nodule characteristics were recorded.ResultsA propensity score-mated cohort analysis was applied to adjust for potential bias and to create two comparable groups according to family history of lung cancer. For our primary analysis, we matched 392 pairs of subjects with family history of lung cancer and subjects without history. Logistic regression showed that female gender and a family history of lung cancer were the two most important predictor of lung cancer in the endemic area with high prevalence of nonsmoking-related lung cancer (OR = 11.199, 95% CI = 1.444–86.862; OR = 2.831, 95% CI = 1.000136–8.015). In addition, the number of nodules was higher in subjects with family history of lung cancer in comparison with subjects without family history of lung cancer (OR = 1.309, 95% CI = 1.066–1.607).ConclusionsIn conclusion, risk-based prediction model based on the family history of lung cancer and female gender can potentially improve efficiency of lung cancer screening programs in Taiwan.
Highlights
Lung cancer has been the leading cause of cancer-related mortality worldwide among both men and women in recent years
The landmark National Lung Screening Trial (NLST) evaluated the benefits of low-dose computed tomography (LDCT) for screening of heavy smokers (≥30 pack-years) and found that annual screening by LDCT yielded a relative reduction of lung cancer mortality of 20% among those screened when compared to chest radiography [3]
We retrospectively review the medical record of 1975 asymptomatic healthy subjects (40 ~ 80 years old) who voluntarily underwent low-dose chest Computed tomography (CT) (1083 males, 892 females) from August 2013 to October 2014
Summary
Lung cancer has been the leading cause of cancer-related mortality worldwide among both men and women in recent years. The purpose of the present study was to investigate multiple potential risk factors for nonsmoking-related lung cancer among Asian Ethnic Groups. Smoking is the major risk factor for lung cancer, Lin et al BMC Pulmonary Medicine (2017) 17:120 propensity score is balanced across treatment and control groups as an alternative to conventional covariate adjustment in logistic regression models [12]. Using propensity score matching analysis, clinical/demographic characteristics of subjects between the groups with family history of lung cancer (+) versus without family history of lung cancer (−) could be balanced out, mimicking randomized controlled trial design. The purpose of the present study was to investigate potential risk factors for nonsmokingrelated lung cancer among Asian population based on propensity score matching analysis which could reduce selection bias and potential baseline differences between the two groups
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