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Principal Investigator
Ping Hu
Position Title
Mathematical Statistician
About this CDAS Project
NLST (Learn more about this study)
Project ID
Initial CDAS Request Approval
Apr 23, 2020
Comparing NLST/PLCO versus Yunnan Tin Miners study with chest X-ray screening: Extended Incidence and Mortality
Lung cancer is the leading cause of cancer death both in USA and China. PLCO showed that no benefit for reducing lung cancer mortality from chest radiograph, while NLST has demonstrated a 20% reduction in mortality from lung cancer with low-dose CT as compared with chest radiography among heavy smokers. However LDCT screening has some limitations with respect to its high false positive rate, costs, radiation burden and from a global point of view shortage of CT capacity. In contrast, chest radiograph is widely available, cheap and relatively lower rate of false positive. In China, the reduced lung cancer mortality was observed in a program of population-based lung cancer screening with chest radiograph and sputum cytology among Yunnan Tin Miners. The lung cancer screening studies conducted in US and China provide a unique opportunity to compare the results of NLST/PLCO versus Yunnan Tin Miners study with chest X-ray screening. The need for these comparisons is driven in part by differences in the histology (more squamous cell carcinoma, less adenocarcinoma) of lung cancer diagnosed in China as compared to the United States, genetic differences between Chinese and American populations.

The primary objectives of this study are:

1) Investigate the difference of lung cancer screening with chest X-rays between Chinese and American population;
2) Study the difference between the screening-detected cases and interval lung cancers in each study and among three studies;
3) Evaluate demography characteristic, clinic characteristic (stage, pathology, etc), and cumulative false positive rate in each study and among three studies.


Youlin QIAO, Professor, Director, Dept. of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College

Yaguang Fan, Associate Professor of Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital