| Abstract: [Purpose] To analyze the lung cancer screening and follow-up results of the Urban Early Detection and Treatment Program for Cancer in Nantong City from 2014 to 2023, a risk factor analysis was performed as well. [Method] According to the technical protocol of the Urban Cancer Early Detection and Treatment Program, the baseline risk assessment, clinical screening, and follow-up information from 2014 to 2023 were collected. Status and survival outcome of lung cancer were obtained via cancer registry and vital statistics system, with follow-up from the date of enrollment to December 31, 2025. The high-risk rate, the screening rate, the cumulative incidence, the mortality rate and the observed survival rate (OSR) were calculated. Univariate analysis was conducted using the chi-square test or the rank-sum test, and multivariate analysis employed logistic regression. In the survival analysis, OSR was calculated using the Kaplan–Meier method. The Log-rank test was used for univariate analysis, and Cox regression was applied for multivariate analysis. Variables that were statistically significant in the univariate analysis (P < 0.05) were included in the multivariate analysis. [Results] Totally 184852 participants were included among whom, 74,914 were male (accounting for 40.53%) and 109938 were female(accounting for 59.47%). There were 31655 cases identified as high risk for lung cancer, accounting for17.12%, among whom 15690 cases received Low-dose CT screening with a compliance rate of 49.57%. From 2014 to 2023, a total of 3250(1.76%) lung cancer cumulative incident cases and 979(0.53%) cases dying of lung cancer were recorded. The 1-year, 3-year and 5-year OSR for lung cancer were 80.26%、73.75% and 69.62%, respectively. The sensitivity of the risk assessment model for lung cancer was 31.51% and the specificity was 83.13%. Male, aging, smoking and history of respiratory diseases were associated with higher lung cancer incidence and mortality, as well as lower OSR. [Conclusion] A paradoxically low high-risk prevalence coupled with high lung cancer detection and mortality rates in Nantong City, alongside improved survival rates for diagnosed patients were observed. Male, aging, smoking and history of respiratory diseases are the key target groups for lung cancer prevention and treatment. Efforts should be actively made to carry out public awareness campaigns, enhance residents'' health literacy, foster awareness of early detection and early treatment of lung cancer, and reduce the health and social burden associated with lung cancer treatment. |
