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Lung Cancer. 2015 Apr;88(1):42-7. doi: 10.1016/j.lungcan.2015.01.014. Epub 2015 Feb 4.

CT screening for lung cancer: Importance of emphysema for never smokers and smokers.

Author information

1
Department of Radiology, Mount Sinai School of Medicine, New York, NY, United States. Electronic address: Claudia.Henschke@mountsinai.org.
2
Department of Radiology, Mount Sinai School of Medicine, New York, NY, United States; Institute of Translational Epidemiology, Mount Sinai School of Medicine, New York, NY, United States.
3
Institute of Translational Epidemiology, Mount Sinai School of Medicine, New York, NY, United States.
4
City University of New York at Queens College, Flushing, NY, United States.
5
Azumi General Hospital, Nagano, Japan.
6
Cancer Hospital, Chinese Academy of Medical Science, Beijing, China.
7
Clinica Universitaria de Navarra, Pamplona, Spain.
8
Department of Radiology, Mount Sinai School of Medicine, New York, NY, United States.

Abstract

PURPOSE:

To address the prevalence of lung cancer in high and low-risk people according to their smoking history, age, and CT findings of emphysema.

METHODS:

We reviewed the baseline low-dose CT scans of 62,124 current, former and never smokers, aged 40-90 to determine the prevalence of lung cancer. We performed logistic regression analysis of the prevalence of lung cancer to determine the odds ratio (OR) for emphysema, conditionally on age, female gender, and ethnicity.

RESULTS:

The prevalence of lung cancer was 1.4% (95% CI: 1.3-1.6) for current smokers, 1.1% (95% CI: 1.0-1.2) for former smokers, and 0.4% (95% CI: 0.3-0.6) for never smokers. Emphysema was identified in 28.5% (6,684), 20.6% (5,422), and 1.6% (194) of current, former, and never smokers, respectively. The prevalence of lung cancer among current smokers was 1.1% for those without emphysema vs. 2.3% for those with emphysema (odds ratio [OR] 1.8; 95% confidence interval [CI]: 1.4-2.2) and the corresponding difference for former smokers was 0.9% vs. 1.8% (OR: 1.7; 95% CI: 1.3-2.2), and for never smokers, it was 0.4% vs. 2.6% (OR: 6.3; 95% CI: 2.4-16.9).

CONCLUSIONS:

Identification of emphysema in low-dose CT scans increases the risk of lung cancer and is important in determining follow-up of current, former, and never smokers.

KEYWORDS:

CT screening; Emphysema; Lung cancer; Never smokers; Secondhand tobacco smoke exposure; Smokers

PMID:
25698134
DOI:
10.1016/j.lungcan.2015.01.014
[Indexed for MEDLINE]

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