European lung cancer screening: valuable trial evidence for optimal practice implementation

Lung cancer screening (LCS) by low-dose computed tomography is a strategy for secondary prevention of lung cancer. In the last two decades, LCS trials showed several options to practice secondary prevention in association with primary prevention, however, the translation from trial to practice is everything but simple. In 2020, the European Society of Radiology and European Respiratory Society published their joint statement paper on LCS. This commentary aims to provide the readership with detailed description about hurdles and potential solutions that could be encountered in the practice of LCS.

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Low-dose computed-tomography lung cancer screening: the first European recommendations from the European Society of Radiology and European Respiratory Society

Polish Archives of Internal Medicine ◽

10.20452/pamw.3029 ◽

2015 ◽

Vol 125 (9) ◽

pp. 607-609 ◽

Cited By ~ 1

Author(s):

Mariusz Adamek ◽

Sylwia Szabłowska-Siwik ◽

Nir Peled ◽

Witold Rzyman ◽

Tomasz Grodzki ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Cancer Screening ◽

European Society ◽

Low Dose ◽

Lung Cancer Screening ◽

European Respiratory Society ◽

European Society Of Radiology ◽

Low Dose Computed Tomography

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LOW-DOSE COMPUTED TOMOGRAPHY IN MOSCOW FOR LUNG CANCER SCREENING (LDCT-MLCS): BASELINE RESULTS

Problems in oncology ◽

10.37469/0507-3758-2019-65-2-224-233 ◽

2019 ◽

Vol 65 (2) ◽

pp. 224-233

Author(s):

Sergey Morozov ◽

Viktor Gombolevskiy ◽

Anton Vladzimirskiy ◽

Albina Laypan ◽

Pavel Kononets ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Cancer Screening ◽

Low Dose ◽

Early Stage ◽

Lung Cancer Screening ◽

Stage I ◽

Malignant Neoplasms ◽

Number Needed To Screen ◽

Low Dose Computed Tomography

Study aim. To justify selective lung cancer screening via low-dose computed tomography and evaluate its effectiveness. Materials and methods. In 2017 we have concluded the baseline stage of “Lowdose computed tomography in Moscow for lung cancer screening (LDCT-MLCS)” trial. The trial included 10 outpatient clinics with 64-detector CT units (Toshiba Aquilion 64 and Toshiba CLX). Special low-dose protocols have been developed for each unit with maximum effective dose of 1 mSv (in accordance with the requirements of paragraph 2.2.1, Sanitary Regulations 2.6.1.1192-03). The study involved 5,310 patients (53% men, 47% women) aged 18-92 years (mean age 62 years). Diagnosis verification was carried out in the specialized medical organizations via consultations, additional instrumental, laboratory as well as pathohistological studies. The results were then entered into the “National Cancer Registry”. Results. 5310 patients (53% men, 47% women) aged 18 to 92 years (an average of 62 years) participated in the LDCT-MLCS. The final cohort was comprised of 4762 (89.6%) patients. We have detected 291 (6.1%) Lung-RADS 3 lesions, 228 (4.8%) Lung- RADS 4A lesions and 196 (4.1%) Lung-RADS 4B/4X lesions. All 4B and 4X lesions were routed in accordance with the project's methodology and legislative documents. Malignant neoplasms were verified in 84 cases (1.76% of the cohort). Stage I-II lung cancer was actively detected in 40.3% of these individuals. For the first time in the Russian Federation we have calculated the number needed to screen (NNS) to identify one lung cancer (NNS=57) and to detect one Stage I lung cancer (NNS=207). Conclusions. Based on the global experience and our own practices, we argue that selective LDCT is the most systematic solution to the problem of early-stage lung cancer screening.

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