ArticleJMIR public health and surveillance2023
Disparity in Lung Cancer Screening Among Smokers and Nonsmokers in China: Prospective Cohort Study.
Article in JMIR public health and surveillance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- LDCT uptake and determinants of lung cancer screening in Asia: a systematic review and meta-analysis.Frontiers in public health · 2025Pooled it
- Recruitment strategies and outcomes in lung cancer screening programmes: a scoping review.European radiology · 2026Article
- Cost-Effectiveness of Universal Low-Dose Computed Tomographic Lung Cancer Screening in Singapore.JAMA network open · 2026Article
- Diagnostic value of lesion-to-spinal cord ratio and apparent diffusion coefficient in differentiating benign and malignant pulmonary nodules and masses.Journal of thoracic disease · 2026Article
- East-West Disparities in Lung Cancer Screening: Subsolid Nodule Prevalence, Interval Growth, and Decision-Making Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Lung cancer in never-smoking females: epidemiology, risk factors and screening.Frontiers in public health · 2026Review
- Lung cancer screening for never smokers: current evidence and future directions.Singapore medical journal · 2026Review
- Understanding East-West differences in subsolid nodules: prevalence and overdiagnosis implications in lung cancer screening.Annals of medicine · 2025Article
- Hospital spending for cancers in Hunan, China during 2017 and 2019.BMC public health · 2025Article
- Lessons Learned From International Lung Cancer Screening Trials; People at Risk Deserve Screening for Early Detection.Respirology (Carlton, Vic.) · 2025Review
- Association between non-alcoholic fatty liver disease and the risk of pulmonary nodules in patients with intestinal polyps.Journal of thoracic disease · 2024Article
- Impact of annual trend volume of low-dose computed tomography for lung cancer screening on overdiagnosis, overmanagement, and gender disparities.Cancer imaging : the official publication of the International Cancer Imaging Society · 2024Article
- Risk factors of recurrence after incisional hernia preperitoneal repair: a long-term retrospective single-center cohort study.Langenbeck's archives of surgery · 2024Article
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow-dose computed tomography (LDCT) screening is effective in reducing lung cancer mortality in smokers; however, the evidence in nonsmokers is scarce.
objectiveThis study aimed to evaluate the participant rate and effectiveness of one-off LDCT screening for lung cancer among smokers and nonsmokers.
methodsA population-based prospective cohort study was performed to enroll participants aged between 40 and 74 years from 2013 to 2019 from 4 cities in Zhejiang Province, China. Participants who were evaluated as having a high risk of lung cancer from an established risk score model were recommended to undergo LDCT screening. Follow-up outcomes were retrieved on June 30, 2020. The uptake rate of LDCT screening for evaluated high-risk participants and the detection rate of early-stage lung cancer (stage 0-I) were calculated. The lung cancer incidence, lung cancer mortality, and all-cause mortality were compared between the screened and nonscreened groups.
resultsAt baseline, 62.56% (18,818/30,079) of smokers and 6% (5483/91,455) of nonsmokers were identified as high risk (P<.001), of whom 41.9% (7885/18,818) and 66.31% (3636/5483) underwent LDCT screening (P<.001), respectively. After a median follow-up of 5.1 years, 1100 lung cancer cases and 456 all-cause death cases (116 lung cancer death cases) were traced. The proportion of early-stage lung cancer among smokers was 60.3% (173/287), which was lower than the proportion of 80.3% (476/593) among nonsmokers (P<.001). Among smokers, a higher proportion was found in the screened group (72/106, 67.9%) than the nonscreened group (56/114, 49.1%; P=.005), whereas no significance was found (42/44, 96% vs 10/12, 83%; P=.20) among nonsmokers. Compared with participants who were not screened, LDCT screening in smokers significantly increased lung cancer incidence (hazard ratio [HR] 1.39, 95% CI 1.09-1.76; P=.007) but reduced lung cancer mortality (HR 0.52, 95% CI 0.28-0.96; P=.04) and all-cause mortality (HR 0.47, 95% CI 0.32-0.69; P<.001). Among nonsmokers, no significant results were found for lung cancer incidence (P=.06), all-cause mortality (P=.89), and lung cancer mortality (P=.17).
conclusionsLDCT screening effectively reduces lung cancer and all-cause mortality among high-risk smokers. Further efforts to define high-risk populations and explore adequate lung cancer screening modalities for nonsmokers are needed.
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