Screening for lung cancer using thin-slice low-dose computed tomography in a Chinese physical examination population: a population-based real-world study

Abstract

Abstract Objectives Lung cancer is one of the most common malignant tumors threatening human life and health. At present, low-dose computed tomography (LDCT) screening for high-risk population to achieve early diagnosis and treatment of lung cancer has become the first choice recommended by many authoritative international medical organizations. Therefore, in order to further optimize the lung cancer screening method, we conducted a real-world study of LDCT lung cancer screening in a large sample of healthy physical examination population, comparing the differences in lung nodules and lung cancer detection between thin and thick-slice LDCT scanning. Methods A total of 29,296 subjects who underwent low-dose thick slice CT scan (5mm thickness) from January 2015 to December 2015 and 28,058 subjects underwent low-dose thin-slice CT scan (1mm thickness) from January 2018 to December 2018 in West China Hospital were included. The positive detection rate, detection rate of lung cancer, pathological stage of lung cancer, and mortality rate of lung cancer were analyzed and compared between the two groups. Results The positive rate of LDCT screening in thin slice was significantly higher than that in thick slice scan group (20.1% vs 14.4%, P < 0.001). In addition, the lung cancer detection rate in the thin-slice LDCT screening positive group was significantly higher than that in the thick slice scanning group (78.0% vs 52.9%, P < 0.001). Conclusions The screening positive rate of low-dose thin-slice CT scan is higher, and more early stage lung cancer (IA1 stage) can be detected in the screen-positive group.