Objective To study the prevalence of combined pulmonary fibrosis and emphysema (CPFE) in a community-based lung cancer screening program in Shanghai. Methods From June 2018 to July 2019, eligible participants who were assessed through a high-risk lung cancer questionnaire in Xuhui, Shanghai underwent low-dose computed tomography of the lungs. The suspected CPFE patients were invited to provide medical history and blood for analysis, and received high-resolution CT (HRCT) scanning for confirmation. Results Of the 15 cases of suspected CPFE from a total of 4478 participants in which 1704 males and 2774 females, 4 declined further examination and 11 received further examine. Eight subjects were confirmed as CPFE, and all were male, of whom two were ex-smokers and six were active smokers. These CPFE patients had cough, chest tightness and dyspnea. There were 3 cases of centrilobular emphysema, 2 cases of paraseptal emphysema, 1 case of panlobular emphysema and 2 cases of mixed emphysema. There were 2 cases of usual interstitial pneumonia, 3 cases of non-specific interstitial pneumonia, 2 cases of airspace enlargement with fibrosis and 1 case of unclassifiable smoking-related interstitial fibrosis. The KBILD scores were 61.7±7.5 and mMRC scores were 1.5±0.8. Serum Krebs von den Lungen-6 concentration was (380.75±212.05)U/mL. Lung function test showed normal or mild restrictive ventilatory function, and mild-moderate impairment in diffusion capacity. Conclusions The prevalence of CPFE is 1.79‰ in a community-based lung cancer screening population, and is 4.69‰ in male lung cancer screening population.
Lung cancer is the leading cause of death among the tumors in the whole world. Although new diagnostic techniques have been developed for nearly 20 years, the mortality is still high. Until now, no randomized controlled trial of chest x-ray and sputum cytology showed the improvement of the survival rate of lung cancer. Low-dose CT can screen more patients in early stage, however, overdiagnosis, cost and the quality of studies should be considered. Further studies of RCTs should be done to clarify these questions.
Lung cancer is the malignant tumor with the highest incidence rate in men and the highest mortality rate in men and women in China, and the incidence and mortality rates are still increasing. Lung cancer screening is an important initiative for early detection of lung cancer and improvement of prognosis. The National Comprehensive Cancer Network (NCCN) updates the NCCN Clinical Practice Guidelines for Lung Cancer Screening annually, and the 2023 V2 edition was released in May 2023. The guidelines are based on the latest research advances and high-level evidence-based medical evidence to establish screening criteria for lung cancer, especially for non-small cell lung cancer, which is the most common and highly regarded type of lung cancer, and has received widespread attention from physicians worldwide. In this article, the latest version of the guideline will be interpreted based on China's national situation and Chinese lung cancer screening guidelines, with the aim of providing an updated reference for lung cancer screening in China.
Early screening is an important means to reduce breast cancer mortality. In order to solve the problem of low breast cancer screening rates caused by limited medical resources in remote and impoverished areas, this paper designs a breast cancer screening system aided with portable ultrasound Clarius. The system automatically segments the tumor area of the B-ultrasound image on the mobile terminal and uses the ultrasound radio frequency data on the cloud server to automatically classify the benign and malignant tumors. Experimental results in this study show that the accuracy of breast tumor segmentation reaches 98%, and the accuracy of benign and malignant classification reaches 82%, and the system is accurate and reliable. The system is easy to set up and operate, which is convenient for patients in remote and poor areas to carry out early breast cancer screening. It is beneficial to objectively diagnose disease, and it is the first time for the domestic breast cancer auxiliary screening system on the mobile terminal.
Pulmonary adenocarcinoma in situ is reclassified as precursor glandular lesions in the fifth edition of WHO classification of thoracic tumours, causing widespread attention and heated debate among domestic thoracic oncologists, radiologists, pathologists and surgeons. We would like to comment on the topic and make a few suggestions on the management of pulmonary nodule during lung cancer screening. We are open to all suggestion and welcome debates.
Lung cancer is the most common cancer and the leading cause of cancer-related death in China. Early screening of lung cancer proves to be effective in improving its prognosis. The National Comprehensive Cancer Network (NCCN) has updated and released version 2, 2022 NCCN clinical practice guidelines for lung cancer screening in July, 2022. Based on high-quality clinical evidence and the latest research progress, the guidelines have developed and updated criteria for lung cancer screening which have been widely recognized by clinicians around the world. Compared with Chinese lung cancer screening guidelines, this article will interpret the updated content of the brand new 2022 NCCN screening guidelines, providing some reference for the current lung cancer screening practice in our country.
Lung cancer ranks first in morbidity and mortality among malignant tumors in China. Low-dose computed tomography (LDCT), as the primary screening method, faces increasingly prominent challenges of false positives and overdiagnosis associated with its high sensitivity. In recent years, the integration of artificial intelligence (AI) and three-dimensional reconstruction technology has provided a novel approach to addressing these challenges. This review highlights how AI and three-dimensional reconstruction contribute to improving image quality, enabling precise identification of pulmonary nodules and intelligent risk stratification, optimizing dynamic follow-up strategies, and assisting in preoperative planning, thereby driving the transformation of the LDCT screening paradigm. Meanwhile, current technical limitations and future directions are also discussed.
ObjectiveTo analyze the age distribution characteristics of breast cancer incidence and mortality across countries and regions worldwide, and to explore the association between the human development index (HDI) and the average age of onset and death of breast cancer, to provide a scientific basis for developing breast cancer prevention and control strategies. MethodsData on female breast cancer incidence and mortality for 185 countries and regions worldwide were obtained from the GLOBOCAN 2022 database, which released by the International Agency for Research on Cancer. This study systematically analyzed the distribution characteristics of the age of onset and death of breast cancer in China and different regions of the world with different levels of HDI and different geographical regions, and explored the relationship between HDI and the average age of onset and death of breast cancer. ResultsIn 2022, there were approximately 2.30 million new cases of female breast cancer worldwide, with an age-standardized incidence rate of 46.80 per 100 000, and approximately 665 300 deaths, with an age-standardized mortality rate of 12.64 per 100 000. The incidence rate was highest in very high HDI regions (75.63 per 100 000), while the mortality rate was highest in low HDI regions (19.11 per 100 000). The average age of breast cancer incidence globally was 58.7 years, and the average age of death was 63.2 years. Both the average age of onset and death of breast cancer increased with the improvement of HDI levels. Specifically, in low HDI regions, the average age of incidence was 51.0 years, and the average age of death was 53.7 years; whereas in very high HDI regions, the average age of breast cancer incidence reached 62.7 years, and the average age of death was 70.0 years. The average age of breast cancer incidence and death in China was slightly lower than the global average level, at 56.0 years and 62.7 years, respectively. From different regions, developed areas such as European regions, North America, and Australia / New Zealand had a relatively higher average ages of incidence, exceeding 61 years; whereas in less-developed areas such as various African regions (excluding South Africa) and Armenia had relatively lower average ages of incidence, as low as under 53 years, especially with the average age of incidence in Central Africa being as low as 50.6 years. The HDI showed a significant positive correlation with both the average age of incidence and death, with correlation coefficients of 0.77 and 0.82, respectively (P<0.001). After adjusting for population age structure, the correlation between the age-standardized average age of incidence and death and HDI slightly decreased, with correlation coefficients of 0.41 and 0.73, respectively (P<0.001). ConclusionsThere were significant regional differences in the age distribution of breast cancer incidence and mortality worldwide, which are closely associated with HDI level. High-HDI regions have a high incidence rates but relatively low mortality rate, while low-HDI regions face a double burden of earlier onset and higher mortality. The age onset of breast cancer in Chinese women is earlier than that in European and American countries, and there are significant regional differences in the age distribution of incidence and mortality compared to other countries. Therefore, the development of prevention and control strategies such as screening should consider the characteristics of breast cancer incidence and mortality distribution by age in China.