Objective: To analyze the risk factors related to lung cancer in participants with low-dose computed tomography (LDCT) screening, to provide data support for identifying high-risk groups of lung cancer and to improve the effectiveness of LDCT lung cancer screening. Methods: A total of 5 366 asymptomatic subjects (2 762 males and 2 604 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The result of LDCT and the risk factors of participants were analyzed. The LDCT positive results were defined as solid or part-solid nodules≥5 mm and non-solid nodule≥8 mm. A total of 12 factors were included and multivariate logistic regression was used to analyze the risk factors associated with lung cancer in the study. Results: Of the 5 366 asymptomatic subjects, 389 were positive and 4 977 were negative for LDCT screening. Among them, 26 of 389 positive cases were confirmed as lung cancers pathologically, and the detection rate of stage I lung cancer was 92.3% (24/26). Multivariate logistic regression showed that age, smoking, low level of education were the relevant risk factors for lung cancer and positive nodules. A stratified analysis of age showed that no risk factors were detected in the 40-49 years old group, while age, smoking, low level of education (primary school and below) were recognized as risk factors in the ≥50 years old group. No statistically significant risk factor was detected between the lung cancer group and the positive nodules group. Conclusions: Age, smoking, and low level of education (primary school and below) are related risk factors for lung cancer and positive nodules. People aged 50 years or older, smoking, and low level of education may be a high risk group for lung cancer. LDCT can effectively detect early lung cancer.
目的： 分析低剂量CT筛查受检者的肺癌相关危险因素，为识别肺癌高危人群、有效进行低剂量CT肺癌筛查提供依据。 方法： 以2014年至2017年在中国医学科学院肿瘤医院防癌体检科行低剂量CT肺癌筛查的5 366例无症状受检者为研究对象，回顾性分析受检者的低剂量CT筛查结果与危险因素调查结果。5 366例受检者中，男性2 762例，女性2 604例。低剂量CT阳性结果定义为实性或部分实性结节≥5 mm、非实性结节≥8 mm。研究纳入分析的因素共12项，采用多因素Logistic回归分析肺癌相关危险因素。 结果： 5 366例无症状受检者中，低剂量CT筛查结果阳性者389例，阴性者4 977例。阳性者中，经病理证实的肺癌为26例，Ⅰ期肺癌检出率达92.3%(24/26)。多因素Logistic回归分析显示，年龄、吸烟、受教育程度为肺癌和阳性结节的独立影响因素。按年龄进行分层分析显示，40～49岁组未检出肺癌和阳性结节的相关危险因素；而≥50岁组则检出3项肺癌和阳性结节的独立影响因素，分别为年龄、吸烟和受教育程度。肺癌组和阳性结节组之间未检出有统计学意义的危险因素。 结论： 年龄、吸烟、受教育程度为肺癌和肺阳性结节的独立影响因素，年龄≥50岁、吸烟、受教育程度较低的人群可能为肺癌的高危人群；低剂量CT可有效检出早期肺癌。.
Keywords: Low-dose CT; Lung neoplasms; Risk factors; Screening.