Key Clinical Summary: 

• Design/Population: A prospective, non-randomized interventional study (Lung-Care project) evaluated low-dose CT screening in a non–risk-based population, compared with a matched unscreened cohort from the same region, with median follow-up of 7 years.
• Key Outcomes: Low-dose CT screening significantly reduced lung cancer mortality, with benefit observed in both men and women. Among diagnosed patients, screen-detected cancers had markedly improved survival. Poorer outcomes were associated with heavy smoking and COPD, while traditional risk-based stratification did not fully capture prognosis.
• Clinical Relevance: Low-dose CT screening may provide substantial mortality benefit beyond high-risk populations, supporting consideration of expanded screening strategies. These results highlight the need to refine risk-based eligibility criteria, particularly in regions with differing lung cancer epidemiology.

According to a prospective analysis of patients enrolled in the Lung-Care project, low-dose computed tomography (CT) screening significantly reduces lung cancer mortality in a non–risk-based population. 

These results were presented at the 2026 European Lung Cancer Congress in Copenhagen, Denmark, by Caichen Li, MD, Guangzhou Medical University, Guangzhou, China.

In this interventional, non-randomized study, patients enrolled in the Lung-Care project underwent low-dose CT screening. A comparison cohort was comprised of patients from the same geographic region and age range who did not undergo screening. Mortality outcomes were analyzed using Cox proportional hazards models, and overall survival (OS) was compared between screen-detected and non-screen detected lung cancer cases. 

At a median follow-up of 7 years, low-dose CT screening was associated with a significantly lower risk of  lung-cancer specific mortality (hazard ratio [HR], 0.45; 95% [confidence interval [CI], 0.32 to 0.65; P < 0.001), observed in both male (HR, 0.55; 95% CI, 0.36 to 0.83; P = 0.004) and female (HR, 0.28; 95% CI, 0.13 to 0.60; P < 0.001) participants. 

Among patients diagnosed with lung cancer, patients who were screen-detected had significantly improved OS compared with patients who were non-screened detected (HR, 0.13; 95% CI, 0.09 to 0.19; P < 0.001). Within the screened cohort, individuals categorized as high risk by NCCN and Chinese guidelines had worse survival outcomes (P < 0.001). Heavy smoking and history of chronic obstructive pulmonary disease (COPD) were associated with worse outcomes (P < 0.001), while other risk factors such as toxic environmental exposures and family history of cancer, were not significantly associated with survival. 

“[Low-dose] CT screening significantly reduces [lung cancer] mortality in a non–risk-based population,” concluded Dr Li. “These findings highlight the potential benefit of extending screening beyond current risk-based eligibility.”

Source:

Li C. The impact of one-time low-dose CT screening on lung cancer mortality in a non–risk-based population: A prospective non-randomized controlled study. Presented at European Lung Cancer Congress. March 25 - 28, 2026. Copenhagen, Denmark. LBA5.