Assessment of Lung Cancer Risk Among Smokers for Whom Annual Screening Is Not Recommended

作者：Charles Faselis, Joel A. Nations, Charity J. Morgan, Jared L. Antevil, Jeffrey M. Roseman, Sijian Zhang, Gregg C. Fonarow, Helen Sheriff, Gregory D. Trachiotis, Richard M. Allman, Prakash Deedwania, Qing Zeng-Trietler, Daniel D. Taub, Amiya Ahmed, George Howard, Ali Ahmed · 发表于：JAMA Oncology · 年份：2022 · DOI：10.1001/jamaoncol.2022.2952 · 被引用次数：34 · 研究领域：Lung Cancer Diagnosis and Treatment、Smoking Behavior and Cessation、Lung Cancer Treatments and Mutations

Importance: The US Preventive Services Task Force does not recommend annual lung cancer screening with low-dose computed tomography (LDCT) for adults aged 50 to 80 years who are former smokers with 20 or more pack-years of smoking who quit 15 or more years ago or current smokers with less than 20 pack-years of smoking. Objective: To determine the risk of lung cancer in older smokers for whom LDCT screening is not recommended. Design, Settings, and Participants: This cohort study used the Cardiovascular Health Study (CHS) data sets obtained from the National Heart, Lung and Blood Institute, which also sponsored the study. The CHS enrolled 5888 community-dwelling individuals aged 65 years and older in the US from June 1989 to June 1993 and collected extensive baseline data on smoking history. The current analysis was restricted to 4279 individuals free of cancer who had baseline data on pack-year smoking history and duration of smoking cessation. The current analysis was conducted from January 7, 2022, to May 25, 2022. Exposures: Current and prior tobacco use. Main Outcomes and Measures: Incident lung cancer during a median (IQR) of 13.3 (7.9-18.8) years of follow-up (range, 0 to 22.6) through December 31, 2011. A Fine-Gray subdistribution hazard model was used to estimate incidence of lung cancer in the presence of competing risk of death. Cox cause-specific hazard regression models were used to estimate hazard ratios (HRs) and 95% CIs for incident lung cancer. Results: There ...