2020 World Lung Cancer Congress: LDCT screening is effective in detecting non-smoking lung cancer patients

Lung cancer is the leading cause of cancer and death worldwide.
2018, about 60% of new lung cancer and deaths worldwide will occur in Asia.
The lung cancer screening risk assessment factors presented in the National Comprehensive Cancer Network (NCCN) guidelines include a history of smoking (now and in the past), a history of radon exposure, a history of occupational exposure (arsenic, chromium, asbestos, nickel, cadmium, radon, silicon, diesel exhaust gas, soot and soot), a history of malignant tumor disease, a family history of first-degree relative lung cancer, a history of chronic obstructive pulmonary swelling or pulmonary fibrosis, and a history of passive smoking.
currently, severe smokers in North America, Europe and parts of Asia are recommended for lung cancer screening using low-dose computer fault scans (LDCT).
is a major risk factor for lung cancer, but lung cancer (LCINS) in non-smokers is also a concern in Asia.
currently, a number of large-scale lung cancer screening trials are under way worldwide to assess the effectiveness of LDCT screening for lung cancer in non-smokers and mild smokers, as well as severe smokers.
, however, NCCN guidelines recommend screening for lung cancer in high-risk groups and not in low- and medium-risk groups.
in the screening method, major guidelines at home and abroad recommend the application of LDCT screening of high-risk groups.
, the 2011 National Lung Cancer Screening Test (NLST), published in the New England Journal of Medicine, further confirms the screening benefits of LDCT, a landmark study of lung cancer screening using LDCT.
, the NELSON study, conducted in Europe and published in the New England Journal of Medicine in 2020, once again demonstrated the benefits of LDCT screening.
In terms of screening conditions, which were slightly different from NLST, the NELSON study patients were 50-74 years old, smoked >15 units/day for at least 25 years, or >10 units/day for at least 30 years, and quit smoking for ≤10 years.
, the researchers found that 53 percent of people who died of lung cancer in our country were never smokers.
the majority of lung cancer screening targets in these trials are mainly heavy smokers, who tend to have higher rates of lung cancer than non-smokers, so this may not be appropriate for the East Asian population.
recently, researchers at Taiwan's Ministry of Health and Welfare published a study that confirmed the effectiveness of LDCT in high-risk groups who never smoke.
the study was recently published at the International Lung Cancer Research Association (IASLC) 2020 World Lung Cancer Congress (WCLC).
this end, a national lung cancer LDCT screening study called the Taiwan Lung Cancer Screening Trial for Non-Smokers (TALENT) was conducted under the leadership of Dr. Pan Zhiyang of the Taipei/Taiwan National Taiwan University School of Medicine.
TALENT is aimed primarily at non-smokers, with the aim of developing effective lung cancer screening strategies for non-smokers and establishing risk prediction models to identify high-risk groups that may benefit from LDCT screening.
TALENT study recruited and tracked 12011 participants who never smoked between 2015.02 and 2019.07.
addition, participants must have one of the following lung cancer risk factors: family history of lung cancer, passive smokers, tuberculosis or chronic obstructive pulmonary disease, cooking index ≥110, and no ventilation during cooking.
results showed that 6,009 (50%) of the 1,2011 people had a family history of lung cancer and 2,094 (17.4%) had positive screening results.
395 of them (3.3 per cent) underwent a lung biopsy or surgery.
313 patients were diagnosed with lung cancer (2.6%), of which 255 (2.1%) were diagnosed with invasive lung cancer -- all but one of them were adenocarcinoma and 96.5% were diagnosed with Stage I disease.
remaining 81 patients were benign lung disease or malignant tumors other than cancer.
, among participants with a family history of lung cancer and no family history of lung cancer, the prevalence of lung cancer was 3.2% and 2.0%, respectively, and the incidence of invasive lung cancer was 2.6% and 1.6%, respectively.
lung cancer increases with the number of first-degree relatives of lung cancer.
"Most importantly, 96.5 percent of patients are stage 0 or 1, and it's possible to be cured by surgery," Dr. Yang said.
, LDCT screening is particularly meaningful for detecting lung cancer patients who are at high risk and who never smoke, given the increasing incidence of lung cancer in non-smokers worldwide.
, the study suggests that a family history of lung cancer may increase the risk of lung cancer.
: TALENT study supports NLCST and NELSON trial results. MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Original" are owned by Mets Medicine and are not authorized to be reproduced by any media, website or individual, and are authorized to be reproduced with the words "Source: Mets Medicine".
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