A Retrospective Analysis: Investigating Factors Linked to High Lung-RADS Scores in a Nonsmoking, Non-Family History Population

TL;DR

This study identifies risk factors for high lung cancer screening scores in nonsmokers without family history, suggesting broader screening criteria.

Contribution

The study identifies new risk factors for lung cancer screening eligibility beyond smoking and family history.

Findings

Age over 55, female gender, and BMI under 23 are linked to high lung cancer scores.

History of respiratory diseases like COPD or asthma increases lung cancer risk scores.

Previous respiratory symptoms like cough or dyspnea are associated with higher screening scores.

Abstract

Low-dose computed tomography screening for lung cancer is currently targeted at heavy smokers or those with a family history of lung cancer. This study aimed to identify risk factors for lung cancer in individuals who do not meet the current lung cancer screening criteria as stipulated by the Taiwan Health Promotion Agency’s low-dose computed tomography (LDCT) screening policy. A cohort analysis was conducted on 12,542 asymptomatic healthy subjects aged 20–80 years old who voluntarily underwent LDCT scans from January 2016 to December 2021. Logistic regression demonstrated that several factors, including age over 55 years, female gender, a body mass index (BMI) less than 23, a previous history of respiratory diseases such as tuberculosis or obstructive respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma), and previous respiratory symptoms such as cough or dyspnea, were associated with high-risk lung radiology scores according to LDCT scans. These findings indicate that risk-based assessments using primary data and questionnaires to identify risk factors other than heavy smoking and a family history of lung cancer may improve the efficiency of lung cancer screening.

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