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Lung Cancer Incidence and Mortality After Negative Low-Dose CT Imaging Screening Results
Huan Liu1, Shipeng Yan2, Pengcheng Liu1
1Department of Epidemiology and Biostatistics and Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Individuals with negative low-dose computed tomography (LDCT) screening results show long-term lung cancer risks similar to low-risk populations. This supports personalized follow-up strategies over routine annual rescreening for better lung cancer management.
Area of Science:
- Pulmonology
- Oncology
- Radiology
Background:
- The clinical significance of negative low-dose computed tomography (LDCT) screening for long-term lung cancer risk stratification is not well-established.
- Uncertainty regarding rescreening intervals for individuals with negative LDCT results persists.
Purpose of the Study:
- To investigate the long-term risks of lung cancer incidence and mortality in individuals who received negative results from LDCT screening.
- To compare these risks with non-screened and low-risk populations.
Main Methods:
- A prospective cohort study was conducted using data from China's National Lung Cancer Screening Program (2012-2019).
- Participants (aged 40-74) were categorized into non-screened, screening-negative, screening-positive, or low-risk groups.
- Inverse probability weighting and Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Main Results:
- Over a median follow-up of 8.61 years, screening-negative individuals had significantly lower lung cancer incidence (HR=0.80) and all-cause mortality (HR=0.77) compared to the non-screened group.
- Lung cancer-specific mortality did not differ significantly between screening-negative and non-screened groups (HR=0.88).
- Risks for screening-negative individuals were comparable to the low-risk group, though currently smoking individuals with negative results showed a higher long-term lung cancer incidence risk.
Conclusions:
- Negative LDCT screening results are associated with generally comparable long-term risks of lung cancer incidence and mortality to those in the low-risk population.
- Findings support risk-stratified follow-up strategies instead of uniform annual rescreening for individuals with negative LDCT results.