{"entity":{"id":"paper-chang-talent-ldct-never-smokers-taiwan-2024","kind":"paper","name":"Low-dose CT screening among never-smokers with or without a family history of lung cancer in Taiwan: a prospective cohort study","aka":[],"tldr":"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.\n\nThe 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.","asOf":"2026-11-04","links":[{"label":"The Lancet Respiratory Medicine 2024 (DOI)","url":"https://doi.org/10.1016/s2213-2600(23)00338-7"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/38042167/"}],"tags":[],"related":[],"cancers":["lung-cancer","nsclc"],"sections":[],"technologies":["low-dose-ct-screening"],"targets":[],"drugs":[],"companies":[],"institutions":["hpa-taiwan"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"The Lancet Respiratory Medicine","year":2024,"doi":"10.1016/s2213-2600(23)00338-7","pmid":"38042167","authors":"Chang GC, Chiu CH, Yu CJ, et al.; TALENT Investigators","paperType":"observational","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%."],"whatItMeans":"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."]},"route":"/key-papers/paper-chang-talent-ldct-never-smokers-taiwan-2024/","neighbours":{"cancer":[{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"technology":[{"id":"low-dose-ct-screening","kind":"technology","name":"Low-dose CT lung screening","route":"/technologies/low-dose-ct-screening/"}],"institution":[{"id":"hpa-taiwan","kind":"institution","name":"Health Promotion Administration, Ministry of Health and Welfare (Taiwan)","route":"/institutions/hpa-taiwan/"}]}}