ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2025
Screening for Lung Cancer, Overdiagnosis, and Healthcare Utilization: A Nationwide Population-Based Study.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Incidence and mortality trends after introduction of lung cancer screening in a community-based healthcare system.Cancer epidemiology · 2026Article
- Patient Shielding in Computed Tomography: Analysis of Influencing Factors and a Conceptual Framework for Decision-Making.Healthcare (Basel, Switzerland) · 2026Review
- Screening Eligibility and Survival Among Patients With Lung Cancer in Korea.JAMA network open · 2026Article
- Improving lung cancer screening diagnostic efficiency.Current opinion in pulmonary medicine · 2026Review
- Diagnostic Yield and Safety of Radial Probe Endobronchial Ultrasound-Guided Transbronchial Lung Cryobiopsy with a Guide Sheath in Pulmonary Lesions < 3 cm.Diagnostics (Basel, Switzerland) · 2026Article
- Stage shifts in national lung adenocarcinoma and the impact of opportunistic self-initiated LDCT screening in Taiwan: a nationwide population-based cohort study.The Lancet regional health. Western Pacific · 2026Article
- Article
- LDCT screening for lung cancer in East Asian never-smokers: balancing benefits and overdiagnosis-related harms.The Lancet regional health. Western Pacific · 2026Review
- Editorial: Advancing diagnostic excellence in early lung cancer detection.Frontiers in oncology · 2026Article
- Understanding East-West differences in subsolid nodules: prevalence and overdiagnosis implications in lung cancer screening.Annals of medicine · 2025Article
- Structured narrative review on lung cancer screening: current evidence, clinical practice implications and implementation insights from a multidisciplinary task force and patient representatives.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Reducing Lung Cancer Disparities Calls for Another Look: Inclusion of Priority Populations in Screening Guidelines.Annals of the American Thoracic Society · 2025Article
- Precision Medicine in Lung Cancer Screening: A Paradigm Shift in Early Detection-Precision Screening for Lung Cancer.Diagnostics (Basel, Switzerland) · 2025Review
- Editorial: Advancements and Challenges in Lung Cancer Screening, Diagnosis, and Management.Diagnostics (Basel, Switzerland) · 2025Article
- Lung cancer screening in people who have never smoked: lessons from East Asia.BMJ (Clinical research ed.) · 2025Article
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
introductionGuideline-discordant low-dose computed tomography (LDCT) screening may cause lung cancer (LC) overdiagnosis, but its extent and consequences are unclear. This study aimed to investigate the prevalence of self-initiated, non-reimbursed LDCT screening in a predominantly non-smoking population and its impact on LC epidemiology and healthcare utilization.
methodsThis nationwide cohort study analyzed data from Korea's National Health Information Database and 11 academic hospital screening centers (1999-2022). The overall analysis encompassed the entire Korean population. For non-reimbursed LDCT screening prevalence, which the National Health Information Database does not capture, a separate analysis was conducted on a cohort of 1.7 million adults to extrapolate nationwide rates. Outcomes included trends in self-initiated, non-reimbursed LDCT screening, LC incidence, mortality, stage and age at diagnosis, 5-year survival, and LC-related healthcare utilization, including surgeries and biopsies. Joinpoint regression assessed trend changes.
resultsSelf-initiated, non-reimbursed LDCT screening during health check-ups increased from 29% to 60% in men and 7% to 46% in women, despite only 2.4% of men and 0.04% of women qualifying for risk-based screening. In women, localized-stage LC incidence nearly doubled (age-standardized incidence rate: from 7.6 to 13.7 per 100,000), whereas distant-stage incidence decreased (age-standardized incidence rate: from 16.1 to 15.0 per 100,000). LC mortality declined (age-standardized mortality rate: from 23.3 to 19.8 per 100,000), whereas 5-year survival rates improved substantially. LC diagnoses in women shifted towards earlier stages and younger ages. Lung surgeries for both malignant and benign lesions, frequently lacking nonsurgical biopsies, increased sharply in women.
conclusionsWidespread guideline-discordant LDCT screening correlates with LC overdiagnosis and increased healthcare utilization, particularly in women. Randomized controlled trials are needed to assess the risks and benefits of screening in low-risk populations to determine its efficacy and consequences.
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