Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Lung Cancer Screening With Low-dose Chest Computed Tomography: Experience From Radon-contaminated Regions in Kazakhstan

  • Received : 2021.11.13
  • Accepted : 2022.03.23
  • Published : 2022.05.31
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Abstract

Objectives: The aim of this study was to present the baseline results of a pilot project conducted to evaluate the effectiveness of lung cancer screening using low-dose chest computed tomography (CT) in regions with excessive radon levels in the Republic of Kazakhstan. Methods: In total, 3671 participants were screened by low-dose chest CT. Current, former, and never-smokers who resided in regions with elevated levels of radon in drinking water sources and indoor air, aged between 40 and 75 with no history of any cancer, and weighing less than 140 kg were included in the study. All lung nodules were categorized according to the American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS 1.0). Results: Overall, 614 (16.7%) participants had positive baseline CT findings (Lung-RADS categories 3 and 4). Seventy-four cancers were detected, yielding an overall cancer detection rate of 2.0%, with 10.8% (8/74) stage I and a predominance of stage III (59.4%; 44/74). Women never-smokers and men current smokers had the highest cancer detection rates, at 2.9% (12/412) and 6.1% (12/196), respectively. Compared to never-smokers, higher odds ratios (ORs) of lung cancer detection were found in smokers (OR,2.48; 95% confidence interval [CI], 1.52 to 4.05, p<0.001) and former smokers (OR, 2.32; 95% CI, 1.06 to 5.06, p=0.003). The most common histologic type of cancer was adenocarcinoma (58.1%). Conclusions: Implementation of low-dose CT screening for lung cancer in regions with elevated radon levels is an effective method for both smokers and never-smokers.

Keywords

Acknowledgement

This study was carried out as part of a pilot project to implement a complex plan to control cancer in the Republic of Kazakhstan. We express our gratitude to the company Ekoservice-C, especially to the employee and expert of the International Nuclear Energy Agency Vladislav Bensman for kindly providing the report "Conducting radiation monitoring of rural settlements in 2008-2011 in the Republic of Kazakhstan."

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