Stage shift, histological differentiation, and survival patterns of lung squamous cell carcinoma versus adenocarcinoma in low-dose CT screening.
Cancer EpidemiolAug 11, 2026 (epub)
Yaguang Fan, Ying Wang, Xuebing Li et al.
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In 30 seconds
This randomized controlled trial compared stage shift, histological differentiation, and survival patterns between lung squamous cell carcinoma (LUSC) and adenocarcinoma (LUAD) in low-dose CT (LDCT) screening. Among 498 LUAD and 249 LUSC cases diagnosed in the LDCT arm, LDCT was associated with higher odds of stage I disease for both types. However, only LUAD showed a significant survival benefit, with an adjusted hazard ratio of 0.54 for lung cancer-specific death.
Key findings
- LDCT increased odds of stage I disease for LUAD (aOR, 2.48) and LUSC (aOR, 1.71).
- LUAD cases had a lower hazard of lung cancer-specific death with LDCT (aHR, 0.54).
- LUSC exhibited lower screening sensitivity and greater prediagnostic tumor size increase compared to LUAD.
- Fewer well-differentiated stage I tumors were found in LUSC than in LUAD.
Why it matters
Understanding the differences in survival outcomes between lung cancer histologies in response to screening can inform clinical decision-making and highlight the need for tailored screening strategies.