EU Policy on Lung Cancer CT Screening 2017

Abstract

Background: Lung cancer kills more Europeans than any other cancer. In 2013, 269,000 citizens of the EU-28 died from this disease. Lung cancer CT screening has the potential to detect lung cancer at an early stage and improve mortality. All of the randomised controlled trials and cohort low-dose CT (LDCT) screening trials across the world have identified very early stage disease (∼70%); the majority of these LDCT trial patients were suitable for surgical interventions and had a good clinical outcome. The 10-year survival in CT screen-detected cancer was shown to be even higher than the 5-year survival for early stage disease in clinical practice at 88%. Methods: Setting up of an EU Commission expert group can be done under Article 168(2) of the Treaty on the Functioning of the European Union, to develop policy and recommendation for Lung cancer CT screening. The Expert Group would undertake: (a) assist the Commission in the drawing up policy documents, including guidelines and recommendations; (b) advise the Commission in the implementation of Union actions on screening and suggest improvements to the measures taken; (c) advise the Commission in the monitoring, evaluation and dissemination of the results of measures taken at Union and national level. Results: This EU Expert Group on lung cancer screening should be set up by the EU Commission to support the implementation and suggest recommendations for the lung cancer screening policy by 2019/2020. Conclusion: Reduce lung cancer in Europe by undertaking a well-organised lung cancer CT screening programme.

Lung Cancer Screening by Low-Dose Computed Tomography: Part 2 – Key Elements for Programmatic Implementation of Lung Cancer Screening

“…Clearly, numerous factors must be taken into account to ensure that the benefit of screening will outweigh the risks of potential harms. European [29,38,39] and German [40] medical societies and expert panels have recommended that screening should be performed exclusively in context of a systematically organized and quality-assured program, regionally organized around expert oncological centers, similar to the key elements outlined above. The German Federal Office for Radiation Protection (Bundesamt für Strahlenschutz, BfS) is currently performing a scientific evaluation of LDCT screening for the reduction of lung cancer mortality, including the systematic modalities required for it to be sufficiently safe and overall beneficial.…”

Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe

“…Risk thresholds need to be periodically reassessed as the distribution of risk factors in a population may change over time and the utility of models may depend on either data availability or population traits. Moreover, the European Position Statement on Lung Cancer Screening [1] and the 2017 EU Policy Document on Lung Cancer Screening [43] emphasised that models should be able to identify individuals with sufficiently high risk to develop lung cancer in order to beneficially impact on the cost-effectiveness of LDCT-LCS. For example, LDCT-LCS is likely to be cost-ineffective in most cases of never-smokers [44], despite that lung cancer continues to remain one of the ten most frequent cancers in this demography group too.…”

Bringing Greater Accuracy to Europe’s Healthcare Systems: The Unexploited Potential of Biomarker Testing in Oncology

“…But multiple research challenges face biomarker development and validation in the context of lung cancer screening, where the interaction between genetics and external factors is multidimensional and hard to control. And so many biomarkers are approaching clinical validation that the field is in great need of standardised metrics of clinical utility – as it is across all cancer types [32, 34].…”