Ontario Lung Cancer Screening Pilot Results – Modern Lung Cancer Screening Performance in a Universal Health Care Setting

Abstract

Abstract Globally, lung cancer is the leading cause of cancer death. The U.S. National Lung Screening Trial and Dutch-Belgium NELSON trial demonstrated that low-dose computed tomography lung cancer screening (LCS) of high-risk individuals can reduce lung cancer mortality by ≥20%. LCS has been approved by major guidelines in the U.S. with over 4,000 different sites offering screening. Adoption of LCS outside of the U.S. has been slow. The Ontario LCS Pilot successfully recruited and enrolled 7768 individuals at high risk for lung cancer between June 1, 2017, and May 31, 2019. 4451 Pilot participants were successfully screened, retained, and provided with high quality follow-up including appropriate treatment as needed. The Pilot lung cancer detection rate and proportion of early-stage disease were high at 2.4% and 79.2%, respectively, and serious harms were low. The Ontario LCS Pilot provides insights into how a modern organized lung screening program can be implemented in a large, diverse, populous geographic area within a universal health care system.