ESR/ERS white paper on lung cancer screening.
Lung cancer is the most frequently fatal cancer, with poor survival once the disease is advanced. Annual low dose computed tomography has shown a survival benefit in screening individuals at high risk for lung cancer. Based on the available evidence, the European Society of Radiology and the European Respiratory Society recommend lung cancer screening in comprehensive, quality-assured, longitudinal programmes within a clinical trial or in routine clinical practice at certified multidisciplinary medical centres. Minimum requirements include: standardised operating procedures for low dose image acquisition, computer-assisted nodule evaluation, and positive screening results and their management; inclusion/exclusion criteria; expectation management; and smoking cessation programmes. Further refinements are recommended to increase quality, outcome and cost-effectiveness of lung cancer screening: inclusion of risk models, reduction of effective radiation dose, computer-assisted volumetric measurements and assessment of comorbidities (chronic obstructive pulmonary disease and vascular calcification). All these requirements should be adjusted to the regional infrastructure and healthcare system, in order to exactly define eligibility using a risk model, nodule management and quality assurance plan. The establishment of a central registry, including biobank and image bank, and preferably on a European level, is strongly encouraged.
Dept of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany Translational Lung Research Center, Member of the German Lung Research Center, Heidelberg, Germany hans-ulrich.kauczor@med.uni-heidelberg.de.
Hans-Ulrich
HU
Kauczor
Institute of Radiology, A. Gemelli University Hospital, Rome, Italy.
Lorenzo
L
Bonomo
7th Respiratory Medicine Dept and Asthma Center, Athens Chest Hospital, Athens, Greece.
Mina
M
Gaga
Dept of Respiratory Diseases/Respiratory Oncology Unit, KU Leuven-University of Leuven, University Hospitals Leuven, Leuven, Belgium.
Kristiaan
K
Nackaerts
Davidoff Cancer Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel.
Nir
N
Peled
Dept of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Mathias
M
Prokop
Dept of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Universite de Lille, Lille, France.
Martine
M
Remy-Jardin
Dept of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany Translational Lung Research Center, Member of the German Lung Research Center, Heidelberg, Germany.
Oyunbileg
O
von Stackelberg
Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Jean-Paul
JP
Sculier
D000368:Aged; D018070:Biological Specimen Banks; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer; D005060:Europe; D005189:False Positive Reactions; D017408:Guidelines as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011336:Probability; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D015272:Pulmonary Medicine / Q000379:methods / Q000592:standards; D012042:Registries; D012307:Risk Factors; D012907:Smoking; D016540:Smoking Cessation; D012955:Societies, Medical