Data Analysis Of Lung Cancer Patients With An Age Of 40 Years Or More Detected By LDCT Screening

Objective:To explore the application value of LDCT lung cancer screening in different age groups through the analysis of clinical,pathology and radiology data for LDCT detected lung cancer cases,improve the effectiveness of LDCT screening for lung cancer.Materials and methods:In this study,we included 10033 participants accepted LDCT lung cancer screening,Cancer Hospital,Chinese Academy of Medical Sciences,and divided them into 3 groups according to their age:40 to 49 years old group,50 to 59 years old group and>60 years old group,then calculated detection rate overall and for different age groups respectively.Clinical,pathology and radiology data of lung cancer patients were collected in detail,and the differences of these information were analyzed among age groups.Statistical analysis for variables data was showed as mean ± standard deviation(X ± S),and we test the difference of it with T test;attributes data’s difference test was analyzed with Chi-square test or Fisher’s exact test,and relative risk was calculated with logistic regression.A P-value lower than 0.05 meaned the difference statistically significant.Results:Lung cancer detection rate:64 lung cancer cases were diagnosed through LDCT among 10033 participants,with 57 cases detected by base line LDCT,7 cases detected by follow-up LDCT,and overall detection rate was 0.6%;lung cancer cases detected for 40 to 49 years old group,50 to 59 years old group and>60 years old group were 15 cases,23 cases and 26 cases respectively,with detection rate 0.4%,0.6%,1.2%respectively.The difference of lung cancer detection rate between age groups was significant(P＝0.001),and increased with age(P＝0.002).Pathological type:adenocarcinoma was 61 cases with percentage 95.3%,and squamous-cell carcinoma,small cell carcinoma and carcinoid was 1 case respectively;no significant differences of pathological types were found among age groups(P＝0.134).Stage:the proportion of stage Ⅰ,Ⅱ,Ⅲ,Ⅳ was 87.7%,5.3%,5.3%,1.7%,respectively.More stage III or IV patients were confirmed in>60 years old group than other groups,and the difference among age groups was statistically significant(P＝0.031).Tumor markers:9 cases appeared CEA increase(9/53,17.0%),among which 7 cases were from ≥60 years old group(7/24,29.2%),higher than other age groups,and the difference was statistically significant(P=0.03).The odds ratio of CEA abnormally increased between ≥60 years old group and 40-49 years old group was 2.059(95%Cl:0.356-11.906).The differences among gender,smoking history,second hand smoking exposure history,malignancy family history,lung cancer differentiation degree,lung cancer size,location and CT density of lung cancer were non-significant(P>0.05)for all age groups.Conclusion:The LDCT lung cancer screening detection rate increased with age.40-49 years old group had the lowest detection rate(0.40%),lower than overall(0.64%).However,≥60 years old group had the highest detection rate(1.20%),among whom the stage III or IV patients proportion rised.Thus,we recommended LDCT lung cancer screening for ≥50 years old people to gurantee more early stage lung cancer cases being detected.Nearly 30%>60 years old group patients had a CEA rise,lung cancer screening for this age group could combine with CEA detection.In this study,we detected 88%stage I lung cancer cases,among which adenocarcinoma was 95%.