One-time low-dose computed tomography (CT) screening for lung cancer in a non–risk-based Chinese population led to a significant reduction in lung cancer mortality, according to the results of a prospective, nonrandomized, controlled study presented at the European Lung Cancer Congress 2026 (Abstract LBA5).
The study authors noted that the findings highlight the potential benefit of extending screening to individuals beyond risk-based eligibility.
Study Methods
Investigators believed that the benefits of low-dose CT screenings for lung cancer in non–risk-based Asian populations warranted further investigation, due to the distinct epidemiological characteristics of lung cancer in Asian populations.
The researchers looked at individuals from the Chinese Lung-Care project between 2017 and 2021, which amounted to almost 12,000 adults between the ages of 40 and 74 years from Guangzhou who had undergone low-dose CT screening. These individuals were geographically and age range matched with a control cohort that received risk-based care.
Subgroup analyses were also conducted within patients who had screen-detected cases of lung cancer by risk factors to determine survival differences.
Key Findings
Individuals were followed for a median of 7 years. During this time, screening significantly reduced the risk of lung cancer death (hazard ratio [HR] = 0.45; 95% confidence interval [CI] = 0.32–0.65; P < .001).
Screening reduced mortality risk for both men (HR = 0.55; 95% CI = 0.36–0.83; P = .004) and women (HR = 0.28; 95% CI = 0.13–0.60; P < .001).
Screen-detected cases of lung cancer showed significantly better overall survival vs those in the control cohort (HR = 0.13; 95% CI = 0.09–0.19; P < .001). Individuals in the screening cohort were more likely to be diagnosed with lung cancer at stage I than those in the nonscreening cohort (81.5% vs 25.1%).
Individuals classified as high risk by guidelines had significantly worse overall survival (P < .001).
Heavy smoking and a history of chronic obstructive pulmonary disease were each associated with worse survival (P < .001). Toxic exposures and personal or family history of cancer were not found to have a significant association with outcome.
“Current screening guidelines were built around smoking history and in doing so, they leave behind a large and growing group of people who develop lung cancer despite never having smoked. In Asia, this is not a marginal issue: never-smoking women represent a substantial share of all lung cancer cases, driven by factors like air pollution and genetic risk rather than tobacco. The LUNG-CARE Project shows that when we screen beyond conventional risk criteria, we catch disease earlier; over 80% of screen-detected cancers were stage I, and that translates directly into lives saved. A 72% mortality reduction in women is not a signal to note; it is a signal to act on,” commented Marina Garassino, MD, University of Chicago, who was not involved in the study.
“This is a game-changer for Asian populations, but we should resist the temptation to overgeneralize. Lung cancer in Asia follows a different epidemiological playbook: neversmokers, women, environmental exposures and guidelines built on Western smoking-based data simply do not serve these populations. On the other hand, Western guidelines cannot simply copy-paste these results. What this study does demand, urgently, is updated criteria that recognize Asian ancestry as an independent risk factor for screening eligibility,” Dr. Garassino concluded.
DISCLOSURE: For full disclosures of the study authors, visit ctimeetingtech.com.
