Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, China
Abstract Background Lung cancer remains a leading cause of cancer-related mortality in urban China, underscoring the urgency of effective screening programs. Despite the proven efficacy of low-dose computed tomography (LDCT) in reducing lung cancer mortality, participation rates among high-risk popu...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-025-14589-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849332781432176640 |
|---|---|
| author | Meijing Liu Suqin Huang Ziru Yu Liling Dai Jin Xiang Yuan Qu Xiuming Zhang Wei Qiao Yan Chen Hairong Zhou Longbiao Zhu Chao Qin Jing Han |
| author_facet | Meijing Liu Suqin Huang Ziru Yu Liling Dai Jin Xiang Yuan Qu Xiuming Zhang Wei Qiao Yan Chen Hairong Zhou Longbiao Zhu Chao Qin Jing Han |
| author_sort | Meijing Liu |
| collection | DOAJ |
| description | Abstract Background Lung cancer remains a leading cause of cancer-related mortality in urban China, underscoring the urgency of effective screening programs. Despite the proven efficacy of low-dose computed tomography (LDCT) in reducing lung cancer mortality, participation rates among high-risk populations remain suboptimal. This study aspired to determine factors influencing LDCT screening adherence among high-risk individuals in Nanjing, China, as part of the China Urban Cancer Screening Project (CanSPUC). Methods A cross-sectional study was conducted from 2019 to 2023, involving 52,910 participants aged 45–74 years. High-risk individuals were identified using a modified Harvard Risk Index adjusted for Chinese demographics. Socio-demographic and clinical data were collected via questionnaires and LDCT reports, with missing values imputed via random forest models. Logistic regression was used to determine the factors associated with LDCT screening adherence. Results Among 16,020 high-risk participants, only 45.4% (7,280/16,020) underwent LDCT. Key factors influencing participation included gender (OR = 1.36, 95% CI:1.24–1.49, p < 0.001), education level (OR = 1.18, 95%CI:1.10–1.26, p < 0.001), occupational exposure (OR = 1.20, 95%CI: 1.11–1.29, p < 0.001), current smoking (OR = 1.26, 95%CI:1.13–1.40, p < 0.001), family cancer history (OR = 1.37, 95%CI:1.28–1.46, p < 0.001), and tuberculosis history (OR = 0.84, 95%CI:0.72–0.97, p = 0.022). LDCT detected lung cancer in 0.47% (34/7,280), with semi-positive nodules observed in 43.16% (3,142/7,280) of screened individuals. Conclusions Despite effective risk stratification, participation in LDCT screening remains low in urban China. Targeted interventions to solve gender disparities, health literacy gaps, and risk communication may be very important to improve the intake rate. Perhaps future efforts should give priority to community-based education, enhanced accessibility, and tailored protocols to reduce lung cancer mortality in high-risk populations. |
| format | Article |
| id | doaj-art-770704d69adf4acdb150d0371d626b73 |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-770704d69adf4acdb150d0371d626b732025-08-20T03:46:07ZengBMCBMC Cancer1471-24072025-07-012511910.1186/s12885-025-14589-9Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, ChinaMeijing Liu0Suqin Huang1Ziru Yu2Liling Dai3Jin Xiang4Yuan Qu5Xiuming Zhang6Wei Qiao7Yan Chen8Hairong Zhou9Longbiao Zhu10Chao Qin11Jing Han12Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityTaixing Center for Disease Control and PreventionJiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityJiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityJiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityJiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityJiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityJiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityJiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityDepartment of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and PreventionDepartment of The Sixth Dental Division, Jiangsu Province Key Laboratory of Oral Diseases, Province Engineering Research Center of Stomatological Translational Medicine, The Affiliated Stomatological Hospital of Nanjing Medical UniversityOffice of Cancer Screening, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical CollegeJiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical UniversityAbstract Background Lung cancer remains a leading cause of cancer-related mortality in urban China, underscoring the urgency of effective screening programs. Despite the proven efficacy of low-dose computed tomography (LDCT) in reducing lung cancer mortality, participation rates among high-risk populations remain suboptimal. This study aspired to determine factors influencing LDCT screening adherence among high-risk individuals in Nanjing, China, as part of the China Urban Cancer Screening Project (CanSPUC). Methods A cross-sectional study was conducted from 2019 to 2023, involving 52,910 participants aged 45–74 years. High-risk individuals were identified using a modified Harvard Risk Index adjusted for Chinese demographics. Socio-demographic and clinical data were collected via questionnaires and LDCT reports, with missing values imputed via random forest models. Logistic regression was used to determine the factors associated with LDCT screening adherence. Results Among 16,020 high-risk participants, only 45.4% (7,280/16,020) underwent LDCT. Key factors influencing participation included gender (OR = 1.36, 95% CI:1.24–1.49, p < 0.001), education level (OR = 1.18, 95%CI:1.10–1.26, p < 0.001), occupational exposure (OR = 1.20, 95%CI: 1.11–1.29, p < 0.001), current smoking (OR = 1.26, 95%CI:1.13–1.40, p < 0.001), family cancer history (OR = 1.37, 95%CI:1.28–1.46, p < 0.001), and tuberculosis history (OR = 0.84, 95%CI:0.72–0.97, p = 0.022). LDCT detected lung cancer in 0.47% (34/7,280), with semi-positive nodules observed in 43.16% (3,142/7,280) of screened individuals. Conclusions Despite effective risk stratification, participation in LDCT screening remains low in urban China. Targeted interventions to solve gender disparities, health literacy gaps, and risk communication may be very important to improve the intake rate. Perhaps future efforts should give priority to community-based education, enhanced accessibility, and tailored protocols to reduce lung cancer mortality in high-risk populations.https://doi.org/10.1186/s12885-025-14589-9Lung cancerEarly detectionHigh-risk population screeningLDCTAdherence |
| spellingShingle | Meijing Liu Suqin Huang Ziru Yu Liling Dai Jin Xiang Yuan Qu Xiuming Zhang Wei Qiao Yan Chen Hairong Zhou Longbiao Zhu Chao Qin Jing Han Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, China BMC Cancer Lung cancer Early detection High-risk population screening LDCT Adherence |
| title | Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, China |
| title_full | Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, China |
| title_fullStr | Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, China |
| title_full_unstemmed | Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, China |
| title_short | Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, China |
| title_sort | assessing factors influencing participation in ldct lung cancer screening among high risk urban populations in nanjing china |
| topic | Lung cancer Early detection High-risk population screening LDCT Adherence |
| url | https://doi.org/10.1186/s12885-025-14589-9 |
| work_keys_str_mv | AT meijingliu assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT suqinhuang assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT ziruyu assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT lilingdai assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT jinxiang assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT yuanqu assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT xiumingzhang assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT weiqiao assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT yanchen assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT hairongzhou assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT longbiaozhu assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT chaoqin assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina AT jinghan assessingfactorsinfluencingparticipationinldctlungcancerscreeningamonghighriskurbanpopulationsinnanjingchina |