2019 Fiscal Year Final Research Report

Individual setting of lung cancer CT screening interval by risk analysis in nested case-control study and model analysis

Research Project

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Project/Area Number	17H04125
Research Category	Grant-in-Aid for Scientific Research (B)
Allocation Type	Single-year Grants
Section	一般
Research Field	Epidemiology and preventive medicine
Research Institution	Tohoku Medical and Pharmaceutical University
Principal Investigator	Sagawa Motoyasu 東北医科薬科大学, 医学部, 教授 (70292274)
Co-Investigator(Kenkyū-buntansha)	薄田勝男金沢医科大学, 医学部, 教授 (00324046) 佐藤雅美鹿児島大学, 医歯学域医学系, 教授 (30250830) 濱島ちさと帝京大学, 医療技術学部, 教授 (30286447) 齋藤博国立研究開発法人国立がん研究センター, 社会と健康研究センター, 部長 (70196004)
Project Period (FY)	2017-04-01 – 2020-03-31
Keywords	肺癌 / 肺がん検診 / 胸部CT検診 / 有効性評価
Outline of Final Research Achievements	Lung cancer is the number one killer of cancer death in Japan. The prognosis of advanced cases is poor, and the results of therapeutic measures are not sufficient. Recently, the number of non-smoker adenocarcinomas has increased, and lung cancer screening is becoming more important. Chest CT screening is promising for reducing lung cancer mortality, but scientific evaluation is essential before introduction. We have developed a large-scale retrospective cohort study in the Hitachi area, and conducted a thorough examination of the enormous missing value. We used several types of simulation methods, and the results were published as an English paper (Nawa, Sagawa, et al. Jap J Clin Oncol 2019). In addition, we are conducting a nested case-control study to set the appropriate screening intervals.
Free Research Field	呼吸器学、がん検診
Academic Significance and Societal Importance of the Research Achievements	低線量胸部CT肺がん検診の有効性評価のために日立地区にて大規模なコホート研究を行い、英文論文として発表した。CT群（17395例）とX線群（15548例）とを長期間観察し、多変量解析により性・年齢・喫煙歴を補正した結果、X線群に対してCT群は肺癌罹患1.23倍、肺癌死亡0.49倍、全死因死亡0.57倍の危険率であった。このことにより、非喫煙者・軽喫煙者を含む地域住民に対する低線量胸部CT肺がん検診が肺癌死亡を低減させる可能性が示唆された。本研究は、非喫煙者・軽喫煙者を含む集団への低線量胸部CT肺がん検診の効果を示唆した世界で初めての研究であり、学術的・社会的に大きな意義を有する。