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Journal of Tuberculosis and Lung Disease ›› 2024, Vol. 5 ›› Issue (2): 106-112.doi: 10.19983/j.issn.2096-8493.2024027

• Original Articles • Previous Articles     Next Articles

Meta-analysis of the impact of low-dose CT screening on population lung cancer-specific mortality and all-cause mortality

Zi Xiaohui, Wu Peng, Zheng Sufei, Sun Nan, He Jie()   

  1. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
  • Received:2024-01-04 Online:2024-04-20 Published:2024-04-11
  • Contact: He Jie
  • Supported by:
    National Key Research and Development Program of China(2022YFC3603003)


Objective: To systematically evaluate the effectiveness of low-dose computed tomography screening (LDCT) in reducing lung cancer-specific mortality and all-cause mortality among screened populations. Methods: A comprehensive search was conducted in databases such as PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform for prospective studies on LDCT lung cancer screening, published domestically and internationally from January 2000 to August 2023. Data extraction and quality assessment were performed on studies meeting the inclusion criteria. The primary outcome was lung cancer-specific mortality, while secondary outcomes included all-cause mortality and the number need to be screened (NNBS) to prevent one lung cancer death or death from all causes. Meta-analysis was conducted using R software version 4.3.1. Results: Nine studies with a prospective design were included, covering 123880 individuals screened, aged 40-75 years. The median follow-up time of the studies ranged from 3.6 to 13.0 years. Meta-analysis results showed that compared to non-LDCT screening groups, LDCT screening reduced lung cancer-specific mortality by 16% (RR=0.84, 95%CI: 0.78-0.91, P<0.001). There was no significant difference in the all-cause mortality (RR=0.93, 95%CI: 0.84-1.03, P=0.151). Subgroup analysis indicated that the specific subcategories of the non-LDCT screening group (control group) were related to the reduction in lung cancer mortality. Meta-regression results showed that the median follow-up time was related to the reduction in all-cause mortality. To prevent one death caused by lung cancer through LDCT screening, 139 people were estimated to be screened in the non-imaging prevention/general population; to prevent one death caused by all-cause, 81 people were estimated to be screened. Conclusion: LDCT screening significantly reduces lung cancer-specific mortality in the 40-75 age group, underlining its important public health significance for specific age groups and risk populations.

Key words: Lung neoplasms, Tomography scanners, X-ray computed, Diagnostic services, Mortality, Meta-analysis as topic

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