Background/Objectives:Lung cancer screening with low-dose computed tomography (LDCT) has reduced lung cancer mortality in high-risk smokers. However, the evidence on LDCT screening in the elderly is limited, with there being few older participants in major trials and ongoing debate about the benefits, risks, and appropriate age limits of LDCT. This study aimed to investigate the prevalence of pulmonary nodules and lung cancer detection rates in men aged 70 and above who underwent a single round of LDCT screening.Methods: We retrospectively analyzed data from elderly male participants aged 70 years or older who underwent a single low-dose CT lung cancer screening at the Veterans Health Service Medical Center between 2010 and 2023. The participants included those who requested screening or were asymptomatic but recommended by physicians. Individuals with prior lung cancer, symptoms suggestive of lung cancer, or suspicious findings on previous imaging were excluded. The nodule prevalence, lung cancer diagnoses, pathological subtypes, and clinical stages were reviewed.Results: A total of 1409 individuals with a mean age of 74.2 years were included. The median follow-up duration was 3.6 years. Among the included individuals, 1304 (92.6%) had a history of smoking. Positive nodules were detected in 179 patients (12.7%, 95% CI: 11.0–14.5%), and lung cancer was diagnosed in 31 patients (2.2%, 95% CI: 1.5–3.1%). Of the diagnosed cases, 14 (45.2%) were adenocarcinomas and 12 (38.7%) were squamous cell carcinomas. Nineteen patients (51.3%) were diagnosed with stage I or II cancer, while seven (22.6%) were diagnosed at stage IV.Conclusions: A single round of LDCT screening in elderly men resulted in a relatively high lung cancer detection rate, with over half of the diagnosed cases being identified at an early stage. This highlights the potential clinical benefit of even one-time screening in enabling timely treatment, which may still be feasible in older adults. However, potential harms such as overdiagnosis should also be considered.
**背景/目的：** 低剂量计算机断层扫描（LDCT）肺癌筛查已降低高风险吸烟者的肺癌死亡率。然而，关于老年人群LDCT筛查的证据有限，主要试验中老年参与者较少，且关于LDCT的获益、风险和适宜年龄上限的争论持续存在。本研究旨在调查接受单轮LDCT筛查的70岁及以上男性中肺结节的检出率及肺癌检出率。 **方法：** 我们回顾性分析了2010年至2023年间在退伍军人健康服务医疗中心接受单次低剂量CT肺癌筛查的70岁及以上老年男性参与者的数据。参与者包括主动要求筛查者或无症状但经医生推荐者。排除既往有肺癌史、有提示肺癌的症状或既往影像学检查有可疑发现者。对结节检出率、肺癌诊断、病理亚型和临床分期进行了分析。 **结果：** 共纳入1409名个体，平均年龄74.2岁。中位随访时间为3.6年。纳入个体中，1304人（92.6%）有吸烟史。179名患者检出阳性结节（12.7%，95% CI：11.0–14.5%），31名患者确诊肺癌（2.2%，95% CI：1.5–3.1%）。确诊病例中，14例（45.2%）为腺癌，12例（38.7%）为鳞状细胞癌。19名患者（51.3%）诊断为I期或II期癌症，而7名患者（22.6%）诊断为IV期。 **结论：** 在老年男性中进行单轮LDCT筛查获得了相对较高的肺癌检出率，且超过一半的确诊病例在早期被发现。这突显了即使是一次性筛查也可能带来临床获益，使其能够及时治疗，这在老年人中可能仍然可行。然而，也应考虑过度诊断等潜在危害。
肿瘤(癌症)患者之家