Universal Lung Cancer Screening Shows Comparable Detection Rates to High-Risk Strategies

Recent research conducted by Professors Jianxing He and Wenhua Liang from the First Affiliated Hospital of Guangzhou Medical University and the National Clinical Research Center for Respiratory Disease has demonstrated that a universal screening approach for lung cancer—applying low-dose computed tomography (LDCT) without restricting to traditional high-risk groups—can achieve detection rates similar to those of risk-based methods.

The study, published in the Journal of the American Medical Association (JAMA), evaluated the effectiveness of screening individuals regardless of their risk factors. The findings reveal that non-high-risk individuals, often overlooked in traditional screening protocols, account for a significant proportion of early-stage lung cancer cases. The comprehensive screening involved over 11,700 residents aged 40–74 in Guangzhou, with nearly 19.2% showing positive findings on LDCT scans. Among those, 200 cases of lung cancer were confirmed, with the majority diagnosed at an early, treatable stage.

Importantly, while conventional high-risk criteria identified only a subset of lung cancers, the non-risk-based strategy captured a larger group of early detections, suggesting that broader screening could reduce missed diagnoses. The sensitivity of LDCT was high (96.6%), and the negative predictive value nearly perfect (99.9%). The study found no significant difference in detection rates between traditional high-risk and non-high-risk groups, indicating that expanding screening beyond high-risk populations could be beneficial.

This approach could be particularly valuable in regions like China, where recent epidemiological trends point to rising lung cancer incidence among younger, non-smoker populations. The project also incorporated detailed questionnaires to identify additional risk factors specific to the local population, aiming to refine screening criteria further.

Data from the study showed a significant reduction in lung cancer mortality among screened individuals compared to unscreened cohorts, highlighting the potential of early detection in improving outcomes. The research underscores the importance of re-evaluating current screening guidelines and advocates for more inclusive, population-based strategies to better identify early lung cancer cases, especially in areas with diverse risk profiles.

Future efforts will focus on developing biomarkers and pre-screening enrichment strategies to enhance detection accuracy and resource allocation, ensuring more individuals benefit from early diagnosis and treatment.