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Impact of low-dose computed tomography screening on lung cancer mortality among asbestos-exposed workers.

Abstract：

Background:We previously showed that low-dose computed tomography (LDCT) screening in asbestos-exposed workers is effective in detecting lung cancer (LC) at an early stage. Here, we evaluate whether LDCT screening could reduce mortality from LC in such a high-risk population. Methods:Within a cohort of 2433 asbestos-exposed men enrolled in an Occupational Health surveillance programme, we compared mortality between the participants in the ATOM002 study (LDCT-P, N  =  926) and contemporary non-participants (LDCT-NP, N  =  1507). We estimated standardized mortality ratios for the LDCT-P and LDCT-NP populations using regional and national rates (SMR_FVG and SMR_ITA, respectively). We compared survival for all causes, all neoplasms, LC and malignant neoplasm of pleura (MNP) between LDCT-P and LDCT-NP using Cox proportional hazard models adjusted for age, smoking history, asbestos exposure level and comorbidities. Results:A reduction in mortality from LC was observed in the LDCT-P group compared with regional and national figures (SMR_FVG  =  0.55, 95% confidence interval (CI) 0.24-1.09; SMR_ITA  =  0.51, 95% CI 0.22-1.01); this was not the case for the LDCT-NP group (SMR_FVG  =  2.07, 95% CI 1.53-2.73; SMR_ITA  =  1.98, 95% CI 1.47-2.61). A strong reduction in LC mortality was observed for the LDCT-P compared with the LDCT-NP [hazard ratio (HR)  =  0.41, 95% CI 0.17-0.96]. Mortality was also reduced for all causes (HR  =  0.61, 95% CI 0.44-0.84), but not for all neoplasms (HR  =  0.97, 95% CI 0.62-1.50) and MNP (HR  =  0.86, 95% CI 0.31-2.41) within the LDCT-P population. Conclusions:In our cohort, participation in the LDCT screening study was associated with reduced mortality from LC. This finding supports the use of LDCT in surveillance programmes for asbestos-exposed workers.

journal_name

Int J Epidemiol

journal_title

International journal of epidemiology

authors

Barbone F,Barbiero F,Belvedere O,Rosolen V,Giangreco M,Zanin T,Pisa FE,Meduri S,Follador A,Grossi F,Fasola G

doi

10.1093/ije/dyy212

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

1981-1991

issue

6

eissn

0300-5771

issn

1464-3685

pii

5132993

journal_volume

47

pub_type

杂志文章

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