China national lung cancer screening guideline with low‐dose computed tomography (2015 version)

Abstract

BackgroundLung cancer is the leading cause of cancer-related death in China. Results from a randomized controlled trial using annual low-dose computed tomography (LDCT) in specific high-risk groups demonstrated a 20% reduction in lung cancer mortality.MethodsA China national lung cancer screening guideline was developed by lung cancer early detection and treatment expert group appointed by the National Health and Family Planning Commission, based on results of the National Lung Screening Trial, systematic review of evidence related to LDCT screening, and protocol of lung cancer screening program conducted in rural China.ResultsAnnual lung cancer screening with LDCT is recommended for high risk individuals aged 50–74 years who have at least a 20 pack-year smoking history and who currently smoke or have quit within the past five years. Individualized decision making should be conducted before LDCT screening. LDCT screening also represents an opportunity to educate patients as to the health risks of smoking; thus, education should be integrated into the screening process in order to assist smoking cessation.ConclusionsA lung cancer screening guideline is provided for the high-risk population in China.

Lung cancer—A global perspective

“…In the United States, the National Lung Screening Trial showed 16‐20% fewer lung cancer deaths among current or former heavy or long‐term smokers (30 pack‐years) who were screened with low‐dose chest CT as opposed to standard chest x‐ray . Annual low‐dose chest CT is the current lung cancer screening recommendation for smokers or former smokers age 55‐74 in several countries including United States, China, and Europe (smoking history indication varies by country) . However, there is uncertainty about the potential harms of screening and generalizability of results which has led to further studies on biomarkers of lung cancer .…”

Glycomic Signatures of Plasma IgG Improve Preoperative Prediction of the Invasiveness of Small Lung Nodules

“…However, 20% of these patients were finally shown to be noninvasive lesions by postoperative pathological diagnosis. Currently, LDCT screening is recommended as an efficient method for the early detection of lung cancer in China [25], with a high sensitivity to detect small pulmonary nodules, even those less than 10 mm in diameter. However, because there is considerable overlap among the imaging features of AAH, AIS, and IA, it is challenging to differentiate noninvasive from invasive nodules by a visual assessment of morphological characteristics based on CT imaging [8].…”

Evaluating lung cancer screening in China: Implications for eligibility criteria design from a microsimulation modeling approach

“…[9] Screening based on environmental or occupational exposure was not incorporated into our current model. Many people in China, especially women, are non-smokers, but are still at an increased risk for lung cancer due to heavy exposure to environmental tobacco smoke at work.…”