AUTHOR=Liu Ya , Feng Zhuowei , Fan Zeyu , Zhang Yu , Li Chenyang , Liu Xiaomin , Duan Hongyuan , Cui Xiaonan , Zhang Liwen , Sheng Chao , Yang Lei , Gao Ying , Wang Xing , Zhang Qing , Lyu Zhangyan , Song Fangfang , Huang Yubei , Song Fengju 

TITLE=Associations of chest X-ray trajectories, smoking, and the risk of lung cancer in two population-based cohort studies

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1203320

DOI=10.3389/fonc.2023.1203320

ISSN=2234-943X

ABSTRACT=Objectives: Despite increasing use of computed tomography (CT), chest X-ray (CXR) remains the first-line investigation for suspected lung cancer (LC) in primary care. However, the associations of CXR trajectories, smoking and LC risk remain unknown.Methods: A total of 52,486 participants from the PLCO and 22,194 participants from the NLST were included. The associations of CXR trajectories with LC risk were evaluated with multivariable COX regression models and pooled with meta-analyses. Further analyses were conducted to explore the stratified associations by smoking status and the factors associated with progression and regression in CXR.Results: Compared to stable negative CXR (CXRSN), HRs(95%CIs) of LC incidence were 2.88(1.50-5.52), 3.86(2.03-7.35), and 1.08(0.80-1.46) for gain of positive CXR (CXRGP), stable positive CXR (CXRSP), and loss of positive CXR (CXRLP), while risk of LC mortality were 1. 58(1.33-1.87),   2.56(1.53-4.29), and 1.05(0.89-1.25). Similar trends were observed across different smoking status.However, LC risk with CXRGP overweighed that with CXRSP among ever smokers [2.