The EU-US Lung Cancer Working Group: Lung cancer screening And Prevention INternationally

ongoing

In Europe, as well as in the US, lung cancer is the leading cause of cancer-related mortality. Lung cancer incidence is concentrated among those at an identifiable high risk, notably by (past) exposure to tobacco. In light of favorable reductions in mortality in trial settings, both the European Commission and the USPSTF recommend regular lung cancer screening(LCS) with Computed Tomography. The EU-US Health Task Force aims to learn from the respective action plans and best practices in LCS and prevent redundancies. To date, CT coverage is challenging, while many issues in implementing a targeted program remain: best scoping and recruitment of the target population (by SES), setting the correct risk threshold for balancing harms to benefits, capacity considerations, optimal smoking cessation interventions, and detailed budget- and health impact analyses per (Member) State(MS). Additionally, exposure to non-tobacco risk factors differs by population. LAPIN(Lung cancer screening And Prevention INternationally) will develop a joint cohort modelling of, first, tobacco exposure and lung cancer epidemiology(WP2). This will produce from health survey data an EU smoking history generator(SHG) to mirror the US-based CISNET SHG. EU MS may use this tool to forecast the burden of lung cancer, over time and by subgroup. Detailed natural history modelling will additionally forecast(WP4) the LCS-preventable share of cancers, weighing benefits to harms of screening. LAPIN will extend on these established methods by incorporating high-risk groups who fall outside tobacco-based eligibility criteria, particularly of radon exposure(WP3). Two stakeholder engagement workshops(WP5) will align the generated knowledge with the needs of those implementing screening at MS level and will summarize best practices in the screening pathway and Action Plans. The impact is likely to be visible at policy level, health professionals, patients and citizens by detailed assessments of European data.