Introduction: The incidence of lung cancer among never‐smokers has been increasing rapidly. The U. S. National Lung Screening Trial and the NELSON trial showed that screening using low‐dose computerized tomography (LDCT) effectively reduced lung cancer mortality among heavy smokers. However, its effectiveness in never‐smokers has not been well investigated. This study investigated the role of LDCT in lung cancer screening among never‐smokers. Methods: The study was designed as a single‐center, retrospective cohort study. We analyzed the data on patients who underwent LDCT screening between May 2003 and June 2016. Nodules detected by computerized tomography were classified according to the Lung Imaging Reporting and Data System criteria. The detection rate and lung cancer outcomes (type of cancer, staging of lung cancer, and mortality) according to smoking history were determined. Results: Of the 28,807 enrolled patients, 12,176 were never‐smokers; of these patients, 7744 (63.6%) were women and 1218 (10.0%) were found to have lung nodules. Overall, lung cancer was diagnosed in 55 never‐smokers (0.45%). In contrast, lung cancer was diagnosed in 143 (0.86%) of the 16,631 ever‐smokers. Of the never‐smokers with lung cancer, 51 (92.7%) presented with stage I disease, and all patients had adenocarcinomas. Conclusions: In the never‐smoker population, LDCT screening helped to detect a significant number of lung cancers. Most of these lung cancers were detected at a very early stage. The positive results of the National Lung Screening Trial in the United States and the NELSON trial may have established the value of LDCT screening for heavy smokers, but future research should consider the value of using LDCT screening in the never‐smoker population.

中文翻译：

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低剂量计算机断层扫描在不吸烟者肺癌筛查中的作用

简介：从不吸烟者肺癌的发病率一直在快速上升。美国国家肺筛查试验和 NELSON 试验表明，使用低剂量计算机断层扫描 (LDCT) 进行筛查可有效降低重度吸烟者的肺癌死亡率。然而，其对从不吸烟者的有效性尚未得到充分研究。本研究调查了 LDCT 在不吸烟者肺癌筛查中的作用。方法：本研究设计为单中心、回顾性队列研究。我们分析了 2003 年 5 月至 2016 年 6 月期间接受 LDCT 筛查的患者的数据。根据肺成像报告和数据系统标准对计算机断层扫描检测到的结节进行分类。检出率和肺癌结果（癌症类型、肺癌分期、和死亡率）根据吸烟史确定。结果：在 28,807 名登记患者中，12,176 名从不吸烟；在这些患者中，7744 名（63.6%）是女性，1218 名（10.0%）被发现有肺结节。总体而言，55 名从不吸烟者（0.45%）被诊断出肺癌。相比之下，在 16,631 名曾经吸烟者中，有 143 名 (0.86%) 被诊断出患有肺癌。在从不吸烟的肺癌患者中，51 人（92.7%）为 I 期疾病，所有患者均为腺癌。结论：在从不吸烟的人群中，LDCT 筛查有助于发现大量肺癌。大多数这些肺癌是在非常早期的阶段被发现的。美国国家肺筛查试验和 NELSON 试验的阳性结果可能已经确立了 LDCT 筛查对重度吸烟者的价值，