Background & Aim: Low-dose computed tomography screening for lung cancer is currently targeted at heavy smokers or those with a family history of lung cancer.
This study aimed to identify risk factors for lung cancer in individuals who do not meet current lung cancer screening criteria as stipulated by the Taiwan Health Promotion Agency’s Low-Dose Computed Tomography (LDCT) screening policy.

Methods: A cohort analysis was conducted on 12,542 asymptomatic healthy subjects aged 20–80 years old who voluntarily underwent LDCT scans from January 2016 to December 2021.

Results: Logistic regression demonstrated that several factors, including age over 55 years, female gender, Body Mass Index (BMI) less than 23, previous history of respiratory diseases such as tuberculosis or obstructive respiratory diseases (Chronic Obstructive Pulmonary Disease [COPD], asthma), and respiratory symptoms such as cough or dyspnea, were associated with high-risk lung radiology scores according to LDCT scans.

Conclusion: These findings indicate that risk-based assessments using primary data and questionnaires to identify risk factors other than heavy smoking and family history of lung cancer may improve the efficiency of lung cancer screening.

Key Messages: The present study aimed to identify risk factors for lung cancer among individuals who do not meet the criteria for LDCT lung cancer screening in Taiwan. The study revealed that age, sex, body mass index (BMI), and significant respiratory symptoms were highly associated with high-risk Lung-RADS scores according to LDCT scans. Additionally, individuals with underlying respiratory diseases and high-risk cooking habits were at risk. Early identification of these risk factors may help target screening and preventative measures toward individuals at high-risk of developing lung cancer.