# Low-dose CT screening among never-smokers with or without a family history of lung cancer in Taiwan: a prospective cohort study

Source: https://onco.cc/key-papers/paper-chang-talent-ldct-never-smokers-taiwan-2024/  
OnCo record `paper-chang-talent-ldct-never-smokers-taiwan-2024` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

TALENT screened 12,011 Taiwanese never-smokers aged 55 to 75 with other risk factors by low-dose CT and found lung cancer in 2.6%, most of it stage I; a family history of lung cancer raised the risk. Taiwan's national screening for people with a family history rests on it.

## Summary

The Taiwan Lung Cancer Screening in Never-Smoker Trial was a nationwide prospective cohort study at 17 tertiary medical centres. Between 1 December 2015 and 31 July 2019 it enrolled 12,011 people aged 55 to 75 (8,868 women) who had never smoked, or had smoked fewer than 10 pack-years and stopped more than 15 years earlier, and had a risk factor: a family history of lung cancer (6,009 people), passive smoking, previous tuberculosis or chronic obstructive lung disease, or heavy or unventilated cooking. This report covers one year after the baseline scan; the study is registered as NCT02611570 and was funded by Taiwan's Ministry of Health and Welfare.

The authors note that in Taiwan lung cancers occur predominantly in never-smokers, nearly 60% of whom have stage IV disease at diagnosis. The Ministry of Health and Welfare cites TALENT as the evidence for including a family history of lung cancer in the national low-dose CT programme that began on 1 July 2022.

## Fields

- Kind: Key paper
- Last checked: 2026-11-04
- Journal: The Lancet Respiratory Medicine
- Year: 2024
- DOI: 10.1016/s2213-2600(23)00338-7
- Authors: Chang GC, Chiu CH, Yu CJ, et al.; TALENT Investigators
- Findings: 2,094 of 12,011 baseline scans (17.4%) were positive.; Lung cancer was diagnosed in 318 people (2.6%): 257 invasive cancers and 61 adenocarcinomas in situ; 317 were adenocarcinomas and 246 (77.4%) were stage I.; Invasive lung cancer was found in 2.7% of those with a family history and 1.6% of those without.; Female sex, a family history and age over 60 were associated with higher risk; passive smoking, cooking exposure and previous lung disease were not.; A positive scan had 92.1% sensitivity, 84.6% specificity and a positive predictive value of 14.0%.
- What it means: Among people who have never smoked, a parent, sibling or child with lung cancer is a strong enough risk factor that Taiwan now screens them, whether or not they smoke.
- Caveats: A cohort without a control group: it measures cancers found, not lives saved.; The authors state that overdiagnosis could have occurred, especially in the adenocarcinomas in situ.; One-year results; follow-up is planned to eight years.

## Sources

- The Lancet Respiratory Medicine 2024 (DOI): https://doi.org/10.1016/s2213-2600(23)00338-7
- PubMed: https://pubmed.ncbi.nlm.nih.gov/38042167/

## Connected records

- cancers: [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- technologies: [Low-dose CT lung screening](https://onco.cc/technologies/low-dose-ct-screening/)
- institutions: [Health Promotion Administration, Ministry of Health and Welfare (Taiwan)](https://onco.cc/institutions/hpa-taiwan/)

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