title: Cancer screening of asymptomatic individuals using 18F-FDG PET/CT in China: a retrospective study.
abstract: In recent years, the application of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for voluntary cancer screening of asymptomatic individuals is becoming more and more popular in China. However, the utility of such screening is still controversial.
  
  
  
  This study enrolled a total of 1,572 asymptomatic individuals who underwent FDG PET/CT as a part of cancer screening program in Shanghai Ruijin Hospital, between January 2010 and December 2014. Whole set of clinical data of each case was retrospectively collected. The cancer detection rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FDG PET/CT were calculated, according to the cancer data obtained from histopathological examinations or at least 12-month clinical follow-up.
  
  
  
  Among the 1,572 subjects, malignant tumors were found in 27 cases (1.72%). The cancer detection rate was 2.74% among subjects who were older than 50 years, 4.72% among those who had a family history of malignant tumors, and 2.77% among those whose tumor markers were positive. These rates were higher than those among other subjects (p<0.05). The detection rate of FDG PET/CT in asymptomatic cancer screening was 1.44%, and the sensitivity, specificity, PPV, and NPV were estimated to be 85.19%, 99.68%, 82.14%, and 99.75%, respectively.
  
  
  
  Considering its less cost-efficient performance, we do not recommend using FDG PET/CT for cancer screening in asymptomatic population. Nevertheless, FDG PET/CT might be a powerful cancer screening modality with the selection of high-risk group, and an optimal combination of the modalities should be provided in order to maximize diagnostic performance with lower costs.
authors.affiliation: Exclusive Medical Care Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.|These authors contributed equally to this article.
authors.forename: Jianjing
authors.initials: J
authors.lastname: Tong
authors.affiliation: Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.|These authors contributed equally to this article.
authors.forename: Yaru
authors.initials: Y
authors.lastname: Zou
authors.affiliation: Department of Emergency Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Emergency Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Shi
authors.affiliation: Department of Emergency Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Ranjun
authors.initials: R
authors.lastname: Tao
authors.affiliation: Department of Emergency Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Ye
authors.affiliation: Department of Emergency Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.|These authors contributed equally to this article.
authors.forename: Xufeng
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, China National Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.|These authors contributed equally to this article.
authors.forename: Weiqing
authors.initials: W
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D019298:Glucose-6-Phosphate / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D012189:Retrospective Studies
chemical_list: C047515:2-fluoro-2-deoxyglucose-6-phosphate; D019298:Glucose-6-Phosphate