Recommendations for the implementation of a national lung cancer screening program in Portugal-A consensus statement.

Lung cancer (LC) is a leading cause of cancer-related mortality worldwide. Lung Cancer Screening (LCS) programs that use low-dose computed tomography (LDCT) have been shown to reduce LC mortality by up to 25 % and are considered cost-effective. The European Health Union has encouraged its Member States to explore the feasibility of LCS implementation in their respective countries. The task force conducted a comprehensive literature review and engaged in extensive discussions to provide recommendations. These recommendations encompass the essential components required to initiate pilot LCS programs following the guidelines established by the World Health Organization. They were tailored to align with the specific context of the Portuguese healthcare system. The document addresses critical aspects, including the eligible population, methods for issuing invitations, radiological prerequisites, procedures for reporting results, referral processes, diagnostic strategies, program implementation, and ongoing monitoring. Furthermore, the task force emphasized that pairing LCS with evidence-based smoking cessation should be the standard of care for a high-quality screening program. This document also identifies areas for further research. These recommendations aim to guarantee that the implementation of a Portuguese LCS program ensures high-quality standards, consistency, and uniformity across centres.

Fernandes MGO ，Dias M ，Santos R ，Ravara S ，Fernandes P ，Firmino-Machado J ，Antunes JP ，Fernandes O ，Madureira A ，Hespanhol V ，Rodrigues C ，Vicente CA ，Alves S ，Mendes G ，Ilgenfritz R ，Pinto BS ，Alves J ，Saraiva I ，Bárbara C ，Cipriano MA ，Figueiredo A ，Uva MS ，Jacinto N ，Curvo-Semedo L ，Morais A ... -  《Pulmonology》

Lung Cancer Screening Initiative in Slovakia: Guidelines of screening implementation.

Juskanic D ，Sandor F ，Denkova L ，Juhos P ，Janik M ，Hontzas J ，Mistinova JP ，Senitko M ，Ondrusova M ... -  《Bratislava Medical Journal-Bratislavske Lekarske Listy》

Accelerating integration of tobacco use treatment in the context of lung cancer screening: Relevance and application of implementation science to achieving policy and practice.

Based on the findings from the National Lung Screening Trial, the U.S. Preventive Services Task Force recommends annual low dose computed tomography (LDCT) lung cancer screening (LCS) among high-risk adults. Approximately 54% of individuals seeking LCS report current cigarette smoking. Effective smoking cessation interventions, offered at the time of LCS, enhances the health benefits of screening that are attributable to reductions in lung cancer overall and tobacco-related mortality. Considering these data, the Centers for Medicare & Medicaid Services' (CMS) 2015 decision to cover LCS with LDCT required that radiology imaging facilities make tobacco cessation interventions available for people who smoke. In February 2022, CMS reversed their 2015 coverage requirement for delivering tobacco use treatment at the time of LDCT; CMS retained the requirement for counseling during the shared decision-making visit prior to the exam. The policy change does not diminish the importance of offering high-quality tobacco cessation services in conjunction with routine LDCT for LCS. However, LCS programs face a range of barriers to implementing tobacco use treatment in their settings. As a result, implementation has lagged. Closing the "evidence to practice" gap is the focus of implementation science, a field that offers a set of rigorous methods and a systematic approach to identifying and overcoming contextual barriers to implementing evidence-based guidelines in a range of clinical settings. In this paper, we describe how implementation science frameworks and methods can be used to help guide LCS programs in their efforts to integrate tobacco use treatment and discuss policy changes needed to further facilitate the delivery of TUT as an essential component of the LCS process.

Shelley D ，Wang VH ，Taylor K ，Williams R ，Toll B ，Rojewski A ，Foley KL ，Rigotti N ，Ostroff JS ... -  《-》

Study rationale and design of the PEOPLHE trial.

Lung cancer screening (LCS) by low-dose computed tomography (LDCT) demonstrated a 20-40% reduction in lung cancer mortality. National stakeholders and international scientific societies are increasingly endorsing LCS programs, but translating their benefits into practice is rather challenging. The "Model for Optimized Implementation of Early Lung Cancer Detection: Prospective Evaluation Of Preventive Lung HEalth" (PEOPLHE) is an Italian multicentric LCS program aiming at testing LCS feasibility and implementation within the national healthcare system. PEOPLHE is intended to assess (i) strategies to optimize LCS workflow, (ii) radiological quality assurance, and (iii) the need for dedicated resources, including smoking cessation facilities. PEOPLHE aims to recruit 1.500 high-risk individuals across three tertiary general hospitals in three different Italian regions that provide comprehensive services to large populations to explore geographic, demographic, and socioeconomic diversities. Screening by LDCT will target current or former (quitting < 10 years) smokers (> 15 cigarettes/day for > 25 years, or > 10 cigarettes/day for > 30 years) aged 50-75 years. Lung nodules will be volumetric measured and classified by a modified PEOPLHE Lung-RADS 1.1 system. Current smokers will be offered smoking cessation support. The PEOPLHE program will provide information on strategies for screening enrollment and smoking cessation interventions; administrative, organizational, and radiological needs for performing a state-of-the-art LCS; collateral and incidental findings (both pulmonary and extrapulmonary), contributing to the LCS implementation within national healthcare systems.

Milanese G ，Silva M ，Ledda RE ，Iezzi E ，Bortolotto C ，Mauro LA ，Valentini A ，Reali L ，Bottinelli OM ，Ilardi A ，Basile A ，Palmucci S ，Preda L ，Sverzellati N ，PEOPLHE consortium ... -  《-》

Cost-effectiveness of lung cancer screening with volume computed tomography in Portugal.

Berge HT ，Togka K ，Pan X ，Borges M ，Martelo FP ，Guedes F ，Cabral D ，Teixeira E ，Fernandes G ，Ferreira L ，Figueiredo S ，Sousa R ，Barradas L ，Estevinho F ，Araújo A ，Hespanhol V ，Medeiros R ... -  《-》