title: Necessity of organized low-dose computed tomography screening for lung cancer: From epidemiologic comparisons between China and the Western nations.
abstract: OBJECTIVE
  To compare the proportion of stage I lung cancer and population mortality in China to those in U.S. and Europe where lung cancer screening by low-dose computed tomography (LDCT) has been already well practiced.
  
  
  METHODS
  The proportions of stage I lung cancer in LDCT screening population in U.S. and Europe were retrieved from NLST and NELSON trials. The general proportion of stage I lung cancer in China was retrieved from a rapid meta-analysis, based on a literature search in the China National Knowledge Infrastructure database. The lung cancer mortality and prevalence of China, U.S. and Europe was retrieved from Globocan 2012 fact sheet. Mortality-to-prevalence ratio (MPR) was applied to compare the population survival outcome of lung cancer.
  
  
  RESULTS
  The estimated proportion of stage I lung cancer in China is merely 20.8% among hospital-based cross-sectional population, with relative ratios (RRs) being 2.40 (95% CI 2.18-2.65) and 2.98 (95% CI 2.62-3.38) compared by LDCT-screening population in U.S. and Europe trials, respectively. MPR of lung cancer is as high as 58.9% in China, with RRs being 0.46 (95% CI 0.31-0.67) and 0.58 (95% CI 0.39-0.85) compared by U.S. and Europe, respectively.
  
  
  CONCLUSIONS
  By the epidemiological inference, the LDCT mass screening might be associated with increasing stage I lung cancer and therefore improving population survival outcome. How to translate the experiences of lung cancer screening by LDCT from developed counties to China in a cost-effective manner needs to be further investigated.
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Hong-Feng
authors.initials: HF
authors.lastname: Gou
authors.affiliation: West China School of Public Health, Sichuan University, Chengdu, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Tian-Xia
authors.initials: TX
authors.lastname: Yang
authors.affiliation: Translational Radiation Oncology, National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany.|Heidelberg Ion Therapy Center (HIT), Department of Radiation Oncology, University Heidelberg Medical School, Heidelberg, Germany.|German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xin-Zu
authors.initials: XZ
authors.lastname: Chen
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality; D002681:China / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000379:methods*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000401:mortality; D008403:Mass Screening / Q000379:methods; D009367:Neoplasm Staging; D011379:Prognosis; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States / Q000453:epidemiology
keywords: epidemiology; low-dose computed tomography; lung cancer; mortality; screening