The following is a summary of “Low-Dose Computed Tomography (LDCT) Lung Cancer Screening in Asian Female Never-Smokers Is as Efficacious in Detecting Lung Cancer as in Asian Male Ever-Smokers: A Systematic Review and Meta-Analysis,” published in the June 2023 issue of the Oncology by Triphuridet et al.

Globally, lung cancer in never-smokers is the leading cause of cancer-related mortality. Using a systematic review and meta-analysis, researchers compared the efficacy of low-dose computed tomography (LDCT) lung cancer screening in never-smokers versus smokers. PubMed and Scopus were searched for LDCT lung cancer screening studies that included both ever-smokers and never-smokers and were published by April 30, 2021. The primary outcome measure was the relative risk (RR) of lung cancer among never-smokers relative to former smokers. There were 14 studies (13 from Asia), including (141,396 ever-smokers, 109,251 never-smokers, and 1,961 lung cancer cases). 

Overall, the relative risk (RR) of lung cancer among ever-smokers was 1.21 (95% CI: 0.89–1.65), 1.37 (95% CI: 1.08–1.75) among men, and 0.88 (95% CI: 0.59–1.31) among women. RR was 1.78 (95% CI: 1.41–2.24) and 1.22 (95% CI: 0.89–1.68) for Asian female never-smokers relative to male never-smokers and male ever-smokers, respectively, and 0.99 (95% CI: 0.65–1.50) relative to high-risk ever-smokers (≥30 pack-years). Never-smokers were significantly more likely to have lung cancer diagnosed at first scan (95.4% [95% CI: 84.9–100.0] versus 70.9% [95% CI: 54.6–84.9], P = 0.010) and at stage 1 (88.5% [95% CI: 79.3–95.4] versus 79.7% [95% CI: 71.1–87.4], P = 0.071) than ever-smokers.

 RR of lung cancer death and 5-year all-cause mortality was 0.27 (95% CI: 0.1–0.55, P<0.001) and 0.13 (95% CI: 0.05–0.33, P<0.001) in never-smokers versus ever-smokers, respectively. In Asia, the RR of lung cancer detected by LDCT screening among never-smoking females and ever-smoking males was statistically comparable. Never-smokers had substantially lower overall and lung cancer-specific mortality from lung cancer diagnosed through LDCT screening than smokers.

Source: sciencedirect.com/science/article/pii/S1556086423001247