Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in China

Abstract Objective This study aimed to evaluate the prognostic factors influencing the survival of patients with lung cancer identified from a lung cancer screening cohort in the community. Methods A total of 25,310 eligible participants were enrolled in this population-based prospective cohort stud...

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Main Authors: Jun Li, Hui-Lin Xu, Wei-Xi Li, Xiao-Yu Ma, Xiao-Hua Liu, Zuo-Feng Zhang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14036-9
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author Jun Li
Hui-Lin Xu
Wei-Xi Li
Xiao-Yu Ma
Xiao-Hua Liu
Zuo-Feng Zhang
author_facet Jun Li
Hui-Lin Xu
Wei-Xi Li
Xiao-Yu Ma
Xiao-Hua Liu
Zuo-Feng Zhang
author_sort Jun Li
collection DOAJ
description Abstract Objective This study aimed to evaluate the prognostic factors influencing the survival of patients with lung cancer identified from a lung cancer screening cohort in the community. Methods A total of 25,310 eligible participants were enrolled in this population-based prospective cohort study, derived from a community lung cancer screening program started from 2013 to 2017. Survival analyses were conducted using the Kaplan–Meier method and the log-rank test. Cox proportional hazards regression models were utilized to identify prognostic factors, including demographic characteristics, risk factors, low-dose CT (LDCT) screening, and treatment information. Results The screening cohort identified a total of 429 patients with lung cancer (276 men, 153 women) during the study period. The 1-year, 3-year, and 5-year survival rates were 74.4%, 59.4% and 54.5%, respectively. The prognostic factors discovered by the multivariate analysis include gender (male vs. female, HR: 2.96, 95% CI: 1.88–4.64), age (HR: 1.02, 95% CI: 1.00–1.05), personal monthly income (2000–3999 CNY vs. < 2000 CNY, HR: 0.70, 95% CI: 0.52–0.95), pathological type (small cell carcinoma vs. adenocarcinoma, HR: 2.55, 95% CI: 1.39–4.66), stage (IV vs. 0-I, HR: 5.21, 95% CI: 2.78–9.75; III vs. 0-I, HR: 3.81, 95% CI: 1.88–7.74), surgery (yes vs. no, HR: 0.36, 95% CI: 0.23–0.57), and KPS (HR: 0.98, 95% CI: 0.98–0.99) among lung cancer patients identified by the basic model. Furthermore, solid nodule (non-solid nodule vs. solid nodule, HR: 0.47, 95% CI: 0.23–0.96) and larger-sized nodule (HR: 1.02, 95% CI: 1.00–1.03) were associated with a worse prognosis for lung cancer in the LDCT screening model. Conclusion Prognostic factors of patients with lung cancer detected by LDCT screening were identified, which could potentially guide clinicians in the decision-making process for lung cancer management and treatment. Further studies with larger sample sizes and more detailed follow-up data are warranted for prognostic prediction.
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spelling doaj-art-4a40768d09ae40f18103df4987a3afbf2025-08-20T02:12:02ZengBMCBMC Cancer1471-24072025-04-0125111210.1186/s12885-025-14036-9Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in ChinaJun Li0Hui-Lin Xu1Wei-Xi Li2Xiao-Yu Ma3Xiao-Hua Liu4Zuo-Feng Zhang5Department of Non-Communicable Diseases Prevention and Control, Shanghai Minhang Center for Disease Control and PreventionDepartment of Non-Communicable Diseases Prevention and Control, Shanghai Minhang Center for Disease Control and PreventionDepartment of Non-Communicable Diseases Prevention and Control, Shanghai Minhang Center for Disease Control and PreventionDepartment of Non-Communicable Diseases Prevention and Control, Shanghai Minhang Center for Disease Control and PreventionDepartment of Non-Communicable Diseases Prevention and Control, Shanghai Minhang Center for Disease Control and PreventionDepartment of Epidemiology, Fielding School of Public Health, University of CaliforniaAbstract Objective This study aimed to evaluate the prognostic factors influencing the survival of patients with lung cancer identified from a lung cancer screening cohort in the community. Methods A total of 25,310 eligible participants were enrolled in this population-based prospective cohort study, derived from a community lung cancer screening program started from 2013 to 2017. Survival analyses were conducted using the Kaplan–Meier method and the log-rank test. Cox proportional hazards regression models were utilized to identify prognostic factors, including demographic characteristics, risk factors, low-dose CT (LDCT) screening, and treatment information. Results The screening cohort identified a total of 429 patients with lung cancer (276 men, 153 women) during the study period. The 1-year, 3-year, and 5-year survival rates were 74.4%, 59.4% and 54.5%, respectively. The prognostic factors discovered by the multivariate analysis include gender (male vs. female, HR: 2.96, 95% CI: 1.88–4.64), age (HR: 1.02, 95% CI: 1.00–1.05), personal monthly income (2000–3999 CNY vs. < 2000 CNY, HR: 0.70, 95% CI: 0.52–0.95), pathological type (small cell carcinoma vs. adenocarcinoma, HR: 2.55, 95% CI: 1.39–4.66), stage (IV vs. 0-I, HR: 5.21, 95% CI: 2.78–9.75; III vs. 0-I, HR: 3.81, 95% CI: 1.88–7.74), surgery (yes vs. no, HR: 0.36, 95% CI: 0.23–0.57), and KPS (HR: 0.98, 95% CI: 0.98–0.99) among lung cancer patients identified by the basic model. Furthermore, solid nodule (non-solid nodule vs. solid nodule, HR: 0.47, 95% CI: 0.23–0.96) and larger-sized nodule (HR: 1.02, 95% CI: 1.00–1.03) were associated with a worse prognosis for lung cancer in the LDCT screening model. Conclusion Prognostic factors of patients with lung cancer detected by LDCT screening were identified, which could potentially guide clinicians in the decision-making process for lung cancer management and treatment. Further studies with larger sample sizes and more detailed follow-up data are warranted for prognostic prediction.https://doi.org/10.1186/s12885-025-14036-9Prognostic factorsSurvivalLung cancerLow-dose CTEarly screening cohortChina
spellingShingle Jun Li
Hui-Lin Xu
Wei-Xi Li
Xiao-Yu Ma
Xiao-Hua Liu
Zuo-Feng Zhang
Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in China
BMC Cancer
Prognostic factors
Survival
Lung cancer
Low-dose CT
Early screening cohort
China
title Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in China
title_full Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in China
title_fullStr Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in China
title_full_unstemmed Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in China
title_short Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in China
title_sort prognostic factors of survival in patients with lung cancer after low dose computed tomography screening a multivariate analysis of a lung cancer screening cohort in china
topic Prognostic factors
Survival
Lung cancer
Low-dose CT
Early screening cohort
China
url https://doi.org/10.1186/s12885-025-14036-9
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