CT lung cancer screening in China: the necessity to optimize target population


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    This thesis focuses on three aspects for optimization of the target population in a potential computed tomography (CT) lung cancer screening program in China: (1) the evaluation of the risk factors for lung cancer, (2) the assessment of the findings from the first-round of CT screening for lung cancer in a Chinese population, and (3) the investigation of the cost-effectiveness and harms of CT lung cancer screening. Part I focuses on contribution of (passive) smoking and airflow limitation on the occurrence of lung cancer. Part II describes the study design of the NELCIN-B3 study in Tianjin and Shanghai, China; and the results of the first-round screening of the NELCIN-B3 study in Tianjin. Part III provides the cost-effectiveness of lung cancer screening in Dutch and Chinese populations and the harms of lung cancer screening. In conclusion, gender specific eligibility criteria for lung cancer screening should be developed due to the differences in risk factors and lung cancer incidence between men and women. Airflow limitation and a passive smoking history play a role in the identification of men and women at an increased risk for the development of lung cancer, respectively. Future studies on the optimization of the entry criteria for lung cancer screening in China should therefore focus on the identification of groups of people at a high risk for the development of lung cancer. Simultaneously, from the perspective of public health, a Chinese lung cancer screening program should be cost-effective, with optimized benefits and minimized harms.
    Originele taal-2English
    KwalificatieDoctor of Philosophy
    Toekennende instantie
    • Rijksuniversiteit Groningen
    • de Bock, Truuske, Supervisor
    • Oudkerk, Matthijs, Supervisor
    • Sidorenkov, Grigory, Co-supervisor
    Datum van toekenning8-dec.-2021
    Plaats van publicatie[Groningen]
    StatusPublished - 2021

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