Low-dose Computed Tomography Lung Cancer Screening Participants Show Improved 10-year Survival Compared With Matched Controls: A Case-Control Study.

OBJECTIVES

This observational case-control study aims to evaluate the prevalence of comorbidities and 10-year overall survival in an LDCT-screened population compared to a propensity score-matched general Polish population.

METHODS

Aged 50-75 years (n=43,686) with at least 10 years of follow-up were included. The screening group (n=7281) underwent LDCT lung cancer screening between 2009 and 2011. The control group (n=36,405) was matched from the general population using 32 variables. The primary endpoint was 10-year overall survival; secondary endpoints included comorbidity prevalence and multivariate analysis results.

RESULTS

Common comorbidities included hypertension (52.2%), chronic coronary artery disease (20.5%), hypercholesterolemia (13.2%), and diabetes (13.0%). Multivariate analysis showed improved survival associated with LDCT screening (HR=0.653), hypertension (HR=0.882), hypercholesterolemia (HR=0.567), and female sex (HR=0.527). The 10-year overall survival was higher in the screening group by 5.6 percentage points (86.9%) compared with controls (81.3%, p<0.001).

CONCLUSIONS

Participation in lung cancer screening using LDCT was associated with longer 10-year overall survival in adults aged 50-75 years. These results support the use of LDCT in high-risk individuals and emphasize the need for prospective studies to elucidate the mechanisms underlying the observed association.