期刊论文详细信息
Frontiers in Oncology
Associations of chest X-ray trajectories, smoking, and the risk of lung cancer in two population-based cohort studies
Oncology
Hongyuan Duan1  Zeyu Fan1  Fengju Song1  Zhuowei Feng1  Chenyang Li1  Yu Zhang1  Zhangyan Lyu1  Chao Sheng1  Fangfang Song1  Xiaomin Liu1  Yubei Huang1  Ya Liu1  Xiaonan Cui2  Qing Zhang3  Xing Wang3  Ying Gao3  Liwen Zhang4  Lei Yang5 
[1] Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Molecular Cancer Epidemiology of Tianjin, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China;Department of Radiology, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China;Health Management Center, Tianjin Medical University General Hospital, Tianjin, China;Hebei Key Laboratory of Environment and Human Health, Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, China;Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital and Institute, Beijing, China;
关键词: lung cancer;    chest X-ray;    trajectory;    smoking;    incidence;    mortality;   
DOI  :  10.3389/fonc.2023.1203320
 received in 2023-04-10, accepted in 2023-06-30,  发布年份 2023
来源: Frontiers
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【 摘 要 】

ObjectivesDespite the increasing use of computed tomography (CT), chest X-ray (CXR) remains the first-line investigation for suspected lung cancer (LC) in primary care. However, the associations of CXR trajectories, smoking and LC risk remain unknown.MethodsA total of 52,486 participants from the PLCO and 22,194 participants from the NLST were included. The associations of CXR trajectories with LC risk were evaluated with multivariable COX regression models and pooled with meta-analyses. Further analyses were conducted to explore the stratified associations by smoking status and the factors associated with progression and regression in CXR.ResultsCompared to stable negative CXR (CXRSN), HRs (95%CIs) of LC incidence were 2.88(1.50–5.52), 3.86(2.03–7.35), and 1.08(0.80–1.46) for gain of positive CXR (CXRGP), stable positive CXR (CXRSP), and loss of positive CXR (CXRLP), while the risk of LC mortality were 1.58(1.33–1.87), 2.56(1.53–4.29), and 1.05(0.89–1.25). Similar trends were observed across different smoking status. However, LC risk with CXRGP overweighed that with CXRSP among ever smokers [2.95(2.25–3.88) vs. 2.59(1.33–5.02)] and current smokers [2.33(1.70–3.18) vs. 2.26(1.06–4.83)]. Moreover, compared to CXRSN among never smokers, even no progression in CXR, the HRs(95%CIs) of LC incidence were 7.39(5.60–9.75) and 31.45(23.58–41.95) for ever and current smokers, while risks of LC mortality were 6.30(5.07–7.81) and 27.17(21.65–34.11). If participants gained positive CXR, LC incidence risk significantly climbed to 22.04(15.37–31.60) and 71.97(48.82–106.09) for ever and current smokers, while LC mortality risk climbed to 11.90(8.58–16.50) and 38.92(27.04–56.02). CXRLP was associated with decreased LC risk. However, even smokers lost their positive CXR, and the increased risks of LC incidence and mortality did not decrease to non-significant level. Additionally, smoking was significantly associated with increased risk of CXRGP but not CXRLP.ConclusionLC risk differed across CXR trajectories and would be modified by smoking status. Comprehensive intervention incorporating CXR trajectories and smoking status should be recommended to reduce LC risk.

【 授权许可】

Unknown   
Copyright © 2023 Liu, Feng, Fan, Zhang, Li, Liu, Duan, Cui, Zhang, Sheng, Yang, Gao, Wang, Zhang, Lyu, Song, Huang and Song

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