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Carlijn van der Aalst
S01 - IASLC CT Screening Symposium: Forefront Advances in Lung Cancer Screening (Ticketed Session) (ID 96)
- Event: WCLC 2019
- Type: Symposium
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:John Kirkpatrick Field, James L Mulshine
- Coordinates: 9/07/2019, 07:00 - 12:00, Colorado Springs (1994)
S01.04 - Lung Cancer Screening: 2019 – Taking Global Implementation Forward (Now Available) (ID 3630)
07:00 - 12:00 | Author(s): Carlijn van der Aalst
With 338,000 EU-deaths annually, lung cancer is a devastating problem. Computed Tomography (CT) screening has the potential to prevent ten-thousands of lung cancer deaths annually. The positive results of the Dutch-Belgian screening trial (NELSON), with relatively low referral rates, and the NLST in the USA provided conclusive evidence. However, implementation is likely to be limited, slow and of variable quality throughout Europe, and current guidelines could easily require up to 25 million CT screens annually. The most optimal strategy in risk-based lung and thoracic screening is still unknown regarding the optimal and most cost-effective (e.g., targeted) strategy 1) to recruit, 2) to include smoking cessation and co-morbidity-reducing services in the context of screening, and 3) to determine the (risk-based) screening interval. Personalised regimens based on the baseline CT result can potentially retain 85% of the mortality reduction achievable through screening at 45% less screens, thus potentially saving much unnecessary harm associated with screening, and 0.5-1 billion Euros per year. But we do not know whether it is safe to have risk-based less intensive screening intervals after a negative baseline CT. Various methods to improve participation of hard-to-reach individuals have to be assessed in different healthcare settings. Innovative co-morbidity reducing strategies have to be tested including other markers on CT imaging, as Calcium Score and COPD. Such implementation research is needed to form the evidence base for risk-based lung cancer screening with huge benefits for the EU, on health outcomes, cost savings, and innovation in the long run.
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