RT Journal Article
SR Electronic
T1 Contemporary issues in the implementation of lung cancer screening
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 200288
DO 10.1183/16000617.0288-2020
VO 30
IS 161
A1 Stephen Lam
A1 Martin Tammemagi
YR 2021
UL http://err.ersjournals.com/content/30/161/200288.abstract
AB Lung cancer screening with low-dose computed tomography can reduce death from lung cancer by 20–24% in high-risk smokers. National lung cancer screening programmes have been implemented in the USA and Korea and are being implemented in Europe, Canada and other countries. Lung cancer screening is a process, not a test. It requires an organised programmatic approach to replicate the lung cancer mortality reduction and safety of pivotal clinical trials. Cost-effectiveness of a screening programme is strongly influenced by screening sensitivity and specificity, age to stop screening, integration of smoking cessation intervention for current smokers, screening uptake, nodule management and treatment costs. Appropriate management of screen-detected lung nodules has significant implications for healthcare resource utilisation and minimising harm from radiation exposure related to imaging studies, invasive procedures and clinically significant distress. This review focuses on selected contemporary issues in the path to implement a cost-effective lung cancer screening at the population level. The future impact of emerging technologies such as deep learning and biomarkers are also discussed.A cost-effective population-based lung cancer screening programme needs an organised approach: equitable recruitment; identification of participants at sufficient risk; nodule management protocol minimising potential harms; integration of smoking cessation. https://bit.ly/3o0jMKN