中国肺癌杂志2026，Vol.29Issue(6)：412-419,8.DOI:10.3779/j.issn.1009-3419.2026.106.15
移动LDCT联合AI社区肺结节筛查检出情况及成本分析
Detection Status and Cost Analysis of Community Pulmonary Nodule Screening with Mobile LDCT Combined with AI
摘要
Abstract
Background and objective Lung cancer is the malignant tumor with the highest morbidity and mortal-ity in China.Low-dose computed tomography(LDCT)is the core method for early lung cancer screening,but traditional fixed-institution screening has the problem of insufficient accessibility at the grassroots level.This study aims to evaluate the detection characteristics and influencing factors of pulmonary nodules by mobile LDCT combined with artificial intelligence(AI)in urban communities of Wuhan,and conduct a preliminary cost analysis from the health system perspective,so as to provide scientific basis for optimizing early screening strategies for pulmonary nodules at the primary care level.Methods A community-based observational study between August 2024 and May 2025 were conducted.A total of 3436 residents in Wuhan communities com-pleted questionnaire surveys and mobile LDCT scans,with a recruitment response rate of 26.7%.Pulmonary nodules were clas-sified according to the Lung CT Screening Reporting and Data System(Lung-RADS).Multivariate Logistic regression model was used to analyze the independent influencing factors of clinically significant nodules(Lung-RADS category≥3).Sensitivity analysis was performed by stepwise backward full-variable model,and multicollinearity was tested by variance inflation factor(VIF).Meanwhile,a descriptive cost analysis was conducted in accordance with the CHEERS 2022 statement.Results The median age of the screened population was 63 years,with 38.7%male and 67.3%aged≥60 years.The overall detection rate of pulmonary nodules was 84.6%,with clinically significant nodules detected in 10.4%and high-risk nodules in 3.2%.Multivariate Logistic regression analysis showed that age 60-79 years(OR=2.771,95%CI:1.004-7.646,P=0.049),age≥80 years(OR=6.224,95%CI:1.813-21.369,P=0.004),heavy smoking(OR=1.919,95%CI:1.352-2.724,P<0.001),secondhand smoke exposure(OR=1.762,95%CI:1.200-2.586,P=0.004),exposure to harmful chemicals(OR=2.972,95%CI:1.881-4.695,P<0.001),long-term kitchen oil fume exposure(OR=1.411,95%CI:1.102-1.807,P=0.006),and family history of lung cancer(OR=1.866,95%CI:1.173-2.967,P=0.008)were independent risk factors for clinically significant nodules.The total cost of the project was 666,580 CNY,with an average screening cost of 194 CNY per person.Under the whole population strategy,the costs for detecting one clinically significant nodule and one high-risk nodule were 1857 and 6060 CNY,respectively.Screening targeted at individuals aged≥60 years could cover 87.3%of high-risk nodules,with the cost per high-risk nodule detected reduced to 4676 CNY.Conclusion Mobile LDCT combined with AI-assisted screening can effectively identify high-risk individuals of pulmonary nodules in community settings.The elderly and people with multiple exposure risks should be the priority popula-tion for screening.This study provides localized screening efficiency parameters and cost data of this model,which can provide practical basis for the optimization of primary pulmonary nodule early screening strategies and subsequent complete health economic evaluation.关键词
肺肿瘤/移动CT/社区筛查/危险因素/成本效益分析Key words
Lung neoplasms/Mobile CT/Community screening/Risk factors/Cost-effectiveness analysis引用本文复制引用
王坚杰,张淏喆,郑志义,李月华,陶军,周美兰,王晓君,吴刚,张正斌,鲁周琴,林清宏,王甜甜..移动LDCT联合AI社区肺结节筛查检出情况及成本分析[J].中国肺癌杂志,2026,29(6):412-419,8.基金项目
本研究受湖北省预防医学会卫生管理创新人才培育行动科研项目(No.2025SWGKY394)资助 This study was supported by the grant from"Innovative Talent Cultivation Program for Health Management"Research Project of the Preventive Medicine Association of Hubei Province(No.2025SWGKY394,to Jianjie WANG). （No.2025SWGKY394）
