Comparative effectiveness of low-dose CT lung cancer screening among high-risk non-smoking female subgroups and males in China

In summary, current lung cancer screening criteria demonstrate limited applicability in female populations, as evidenced by significantly lower LDCT adherence, positive rates, and detection rates among non-smoking females compared to smoking males. Critically, we identified a well-defined subgroup of non-smoking females characterized by combined passive smoking and hormonal abnormalities. This subgroup exhibited screening outcomes that were not statistically significantly different from those observed in male populations. These findings support the development of more precise, risk-stratified screening criteria that better account for sex-specific differences in lung cancer risk and clinical presentation.