Towards personalized lung cancer CT screening in Europe

Two large-scale RCTs have shown Computed Tomography (CT) lung cancer screening to be efficacious in reducing lung cancer mortality (8-24% in men, versus 26-59% in women). However, implementation is likely to be limited, slow and of variable quality throughout Europe, because of important remaining uncertainties, which have been incompletely addressed or not at all so far. Our 4-IN-THE-LUNG-RUN (TOWARDS INDIVIDUALLY TAILORED INVITATIONS, SCREENING INTERVALS, AND INTEGRATED CO-MORBIDITY REDUCING STRATEGIES IN LUNG CANCER SCREENING) proposal is the first multi-centered implementation trial on volume CT lung cancer screening amongst 26,000 males and females, at high risk for developing lung cancer, across five European countries. Main objective is to assess whether lung cancer stage I/II is comparable between personalized screening (biennial) and annual screening in baseline test negatives (24,000; 1:1). We envisage that with the answers to key questions established by this trial, many European citizens will swiftly benefit from this high-quality screening technology, others will face less harms than previously anticipated, and health care costs will be reduced to a large extent. 4-IN-THE-LUNG-RUN is performed by a multidisciplinary consortium of leading experts in the field of population-based cancer screening (NELSON, UKLS, ITALUNG, LUSI), CT imaging, biomarkers, treatment, modelling, and understanding health behaviour, and in both new and existing high quality centres. Aim of the presentation is to introduce the study design, the eligibility for participating in the trial and mentioning the challenges in the recruitment, smoking cessation, and CAC research.