Low-dose CT lung cancer screening in never-smokers and smokers: Results of an eight-year observational study

Ryutaro Kakinuma, Yukio Muramatsu, Hisao Asamura, Shun Ichi Watanabe, Masahiko Kusumoto, Takaaki Tsuchida, Masahiro Kaneko, Koji Tsuta, Akiko Miyagi Maeshima, Genichiro Ishii, Kanji Nagai, Taiki Yamaji, Takahisa Matsuda, Noriyuki Moriyama

Research output: Contribution to journalArticle

Abstract

Background: This was an observational study of Japanese participants who underwent low-dose computed tomographic (LDCT) lung cancer screening between February 2004 and March 2012, to evaluate the lung cancers in never-smokers and smokers. Methods: The study population consisted of a total of 12,114 subjects [never-smokers, 6,021 (49.70%); smokers with <30 pack-years of smoking, 3,785 (31.24%); smokers with ≥30 pack-years of smoking, 2,305 (19.03%); unknown smoking status, 3 (0.02%)]. The odds ratio (OR) of lung cancer detection according to the smoking status adjusted for age and gender was evaluated. Results: A total of 152 lung cancers were diagnosed in 133 patients [never-smokers, 66 (49.6%); smokers with <30 pack-years of smoking, 31 (23.3%); smokers with ≥30 pack-years of smoking, 36 (27.1%)]; therefore, 72.9% of lung cancer patients did not meet the National Lung Screening Trial (NLST) criterion of smokers with ≥30 pack-years of smoking. The OR of lung cancer detection in smokers with ≥30 packyears of smoking was higher than that in the never-smokers (OR =1.71, 95% CI: 1.04.2.82, P=0.03) and that in smokers with <30 pack-years of smoking (OR =1.71, 95% CI: 1.04.2.80, P=0.03), while the OR of lung cancer detection in smokers with <30 pack-years of smoking was the same as that in the never-smokers (OR =1.00, 95% CI: 0.62.1.61, P=0.99). Conclusions: Although the OR of lung cancer detection in smokers with ≥30 pack-years of smoking was higher than that in the never-smokers and smokers with <30 pack-years of smoking, approximately 70% of lung cancer patients might be missed if we only adopted the NLST criterion of smokers with ≥30 pack-years of smoking. Therefore, never-smokers and smokers with <30 pack-years of smoking should be included in the target population for LDCT lung cancer screening in Japan.

Original languageEnglish
Pages (from-to)10-22
Number of pages13
JournalTranslational Lung Cancer Research
Volume9
Issue number1
DOIs
Publication statusPublished - 2020 Feb 1

Keywords

  • Adenocarcinoma
  • Low-dose computerized tomography
  • Lung cancer screening
  • Never-smoker

ASJC Scopus subject areas

  • Oncology

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  • Cite this

    Kakinuma, R., Muramatsu, Y., Asamura, H., Watanabe, S. I., Kusumoto, M., Tsuchida, T., Kaneko, M., Tsuta, K., Maeshima, A. M., Ishii, G., Nagai, K., Yamaji, T., Matsuda, T., & Moriyama, N. (2020). Low-dose CT lung cancer screening in never-smokers and smokers: Results of an eight-year observational study. Translational Lung Cancer Research, 9(1), 10-22. https://doi.org/10.21037/tlcr.2020.01.13