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Supporting the implementation of lung cancer screening: a focus on data management and programme evaluation
To help those planning to implement screening programmes, the Network has published a policy brief focused on importance of data management and programme evaluation.
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Supporting the implementation of lung cancer screening: a focus on developing a clear protocol for LDCT screening
To help those planning to implement screening programmes, the Network has published a policy brief focused on developing a clear protocol for LDCT screening.
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Supporting the implementation of lung cancer screening: a focus on financial planning
To help those planning to implement screening programmes, the Network has published a policy brief focused on the importance of financial planning.
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Supporting the implementation of lung cancer screening: a focus on eligibility and recruitment
To help those planning to implement screening programmes, the Network has published a policy brief focused on eligibility requirements and recruitment.
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Supporting the implementation of lung cancer screening: a focus on workforce and technical capacity requirements
To help those planning to implement screening programmes, the Network has published a policy brief focused on workforce and technical capacity requirements.
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Supporting the implementation of lung cancer screening: a focus on governance
To help those planning to implement screening programmes, the Network has published a policy brief focusing on the importance of governance.
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An introduction to the Lung Cancer Policy Network’s implementation framework
This video details how the Network's framework can be used to support the implementation of LDCT lung cancer screening. The framework facilitates a robust assessment of the actions needed across all parts of the health system to optimise this implementation.
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Webinar: How can health systems optimise the implementation of lung cancer screening?
In May 2023 the Lung Cancer Policy Network hosted a webinar where Network members and guest speakers shared their expertise in lung cancer and health system readiness, highlighting different approaches to optimising implementation.
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Lung cancer screening implementation toolkit
Lung Cancer Policy Network (2023)
The Lung Cancer Policy Network has developed a suite of resources to support those involved in the planning of lung cancer screening programmes around the world.
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The Lung Cancer Policy Network has developed a suite of resources to support those involved in the planning of lung cancer screening programmes around the world.
A framework to support the implementation of LDCT lung cancer screening (Version 1)
Lung Cancer Policy Network (2023)
The Lung Cancer Policy Network has developed an implementation framework to support those involved in the planning of lung cancer screening programmes around the world.
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The Lung Cancer Policy Network has developed an implementation framework to support those involved in the planning of lung cancer screening programmes around the world.
Research methodology
Lung Cancer Policy Network (2023)
This document outlines the research methodology used to inform the development of an implementation framework to support the implementation of LDCT screening.
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This document outlines the research methodology used to inform the development of an implementation framework to support the implementation of LDCT screening.
HUNT Lung Cancer Model
Norwegian University of Science and Technology & University of Crete
A model that may be used to understand the risk of developing lung cancer in people who have ever smoked. For more information, including how the model was validated, see the accompanying peer-reviewed publication by Markaki et al (2018).
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A model that may be used to understand the risk of developing lung cancer in people who have ever smoked. For more information, including how the model was validated, see the accompanying peer-reviewed publication by Markaki et al (2018).
Types of data and potential requirements for setting up a screening programme
Lung Cancer Policy Network (2023)
This resource explores top-line examples of the types of data that might be needed to support the set-up of an organised screening programme. It also looks at existing data management systems that the programme may be required to access and provides a range of sources of data.
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This resource explores top-line examples of the types of data that might be needed to support the set-up of an organised screening programme. It also looks at existing data management systems that the programme may be required to access and provides a range of sources of data.
Summary of different approaches to the evaluation of lung nodules
Lung Cancer Policy Network (2023)
This resources touches on the need for a standardised approach to nodule management and gives examples of protocols for the evaluation of results from LDCT screening.
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This resources touches on the need for a standardised approach to nodule management and gives examples of protocols for the evaluation of results from LDCT screening.
Example pathway for managing results from LDCT screening
Lung Cancer Policy Network (2023)
This infographic depicts a pathway along which a participant in an LDCT screening programme for lung cancer would travel, drawing on examples from Australia and Canada.
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This infographic depicts a pathway along which a participant in an LDCT screening programme for lung cancer would travel, drawing on examples from Australia and Canada.
Templates for understanding which populations might be at highest risk of lung cancer
Lung Cancer Policy Network (2023)
This resource may serve as a starting point for collecting top-line data to support the identification of the target population for a lung cancer screening programme. It is split into multiple templates to support users in outlining the population-level incidence and mortality from lung cancer, the smoking prevalence, and the stage at which lung cancer is most commonly diagnosed in the health system in question.
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This resource may serve as a starting point for collecting top-line data to support the identification of the target population for a lung cancer screening programme. It is split into multiple templates to support users in outlining the population-level incidence and mortality from lung cancer, the smoking prevalence, and the stage at which lung cancer is most commonly diagnosed in the health system in question.
Summary of potential barriers to and solutions for engaging participants in screening
Lung Cancer Policy Network (2023)
This resource discusses examples of some of the identified barriers to screening participation and explores some of the ways these can be addressed to improve engagement with screening.
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This resource discusses examples of some of the identified barriers to screening participation and explores some of the ways these can be addressed to improve engagement with screening.
Selected risk prediction models used in lung cancer screening
Lung Cancer Policy Network (2023)
An infographic of example risk prediction models that may be used to identify the target population for lung cancer screening.
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An infographic of example risk prediction models that may be used to identify the target population for lung cancer screening.
Potential costs to consider for lung cancer screening programmes
Lung Cancer Policy Network (2023)
This summary table provides examples of costs to consider when planning for screening programme implementation. It can be used to help identify potential sources of financing for setting up the programme and to determine how costs for maintaining the programme will be funded in the long term.
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This summary table provides examples of costs to consider when planning for screening programme implementation. It can be used to help identify potential sources of financing for setting up the programme and to determine how costs for maintaining the programme will be funded in the long term.
Template for an initial assessment of workforce capacity for lung cancer screening
Lung Cancer Policy Network (2023)
This template provides a suggested structure for mapping the availability of healthcare professionals who could be involved in lung cancer screening. It may serve as a starting point for understanding potential deficits in workforce capacity across a health system as a lung cancer screening programme is set up and later expanded.
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This template provides a suggested structure for mapping the availability of healthcare professionals who could be involved in lung cancer screening. It may serve as a starting point for understanding potential deficits in workforce capacity across a health system as a lung cancer screening programme is set up and later expanded.
Additional considerations for planning technical and workforce capacity for lung cancer screening
Lung Cancer Policy Network (2023)
This summary seeks to provide examples of healthcare professionals who may be responsible for each component of a screening programme and the possible activities involved.
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This summary seeks to provide examples of healthcare professionals who may be responsible for each component of a screening programme and the possible activities involved.
Stakeholder groups that may be involved in lung cancer screening
Lung Cancer Policy Network (2023)
A summary of some of the healthcare professionals and organisations that it is important to consult when planning to introduce an organised screening programme for lung cancer.
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A summary of some of the healthcare professionals and organisations that it is important to consult when planning to introduce an organised screening programme for lung cancer.
Domains of the framework to support the implementation of LDCT lung cancer screening
Lung Cancer Policy Network (2023)
This visual summary demonstrates the implementation framework and its six key domains. The framework aims to enable a comprehensive assessment of readiness for the implementation of lung cancer screening.
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This visual summary demonstrates the implementation framework and its six key domains. The framework aims to enable a comprehensive assessment of readiness for the implementation of lung cancer screening.
Methodology flow diagram
Lung Cancer Policy Network (2023)
A summary diagram to illustrate the research methodology for the development of a framework to support the implementation of LDCT lung cancer screening.
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A summary diagram to illustrate the research methodology for the development of a framework to support the implementation of LDCT lung cancer screening.
Lung cancer screening: Learning from implementation
Lung Cancer Policy Network (2022)
The Network developed this report to highlight the wealth of research on the implementation of lung cancer screening, supported by a variety of global case studies. The report also provides four practical lessons that provide a blueprint for governments and other institutions to build their own targeted screening programmes.
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The Network developed this report to highlight the wealth of research on the implementation of lung cancer screening, supported by a variety of global case studies. The report also provides four practical lessons that provide a blueprint for governments and other institutions to build their own targeted screening programmes.
Online course: Lung cancer and the primary care provider
LuCa National Training Network (N/A)
A free online course from the University of Louisville designed to support healthcare professionals in communicating with potential participants of a lung cancer screening programme. The course covers screening, shared decision-making, treatment advances, follow-up and survivorship care over 2.5 hours of continuing medical education (CME) training.
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A free online course from the University of Louisville designed to support healthcare professionals in communicating with potential participants of a lung cancer screening programme. The course covers screening, shared decision-making, treatment advances, follow-up and survivorship care over 2.5 hours of continuing medical education (CME) training.
An Overview of Medicaid, Medicare and Private Insurance Coverage (report series)
LuCa National Training Network (2019)
A selection of reports designed by the LuCa National Training Network and Harvard Law School's Center for Health Law and Policy Innovation to support healthcare professionals, advocates and patients in understanding the screening and smoking cessation interventions available in the US. Further resources compiled by the LuCa National Training Network are available in an online library.
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A selection of reports designed by the LuCa National Training Network and Harvard Law School's Center for Health Law and Policy Innovation to support healthcare professionals, advocates and patients in understanding the screening and smoking cessation interventions available in the US. Further resources compiled by the LuCa National Training Network are available in an online library.
European Cancer Inequalities Registry
European Commission (N/A)
A flagship initiative of Europe's Beating Cancer Plan that provides reliable data on cancer prevention and care to identify trends, disparities and inequalities between Member States and regions. The registry and associated resources may be used to understand the target population for lung cancer screening and take a deeper dive into the policy context in each country.
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A flagship initiative of Europe's Beating Cancer Plan that provides reliable data on cancer prevention and care to identify trends, disparities and inequalities between Member States and regions. The registry and associated resources may be used to understand the target population for lung cancer screening and take a deeper dive into the policy context in each country.
The Global Burden of Disease
Institute for Health Metrics and Evaluation, University of Washington (N/A)
The Global Burden of Disease (GBD) is a comprehensive resource that visualises health data over time, across countries, and by age and sex. The interactive tool quantifies and enables the comparison of data on hundreds of risk factors, injuries and diseases, including lung cancer.
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The Global Burden of Disease (GBD) is a comprehensive resource that visualises health data over time, across countries, and by age and sex. The interactive tool quantifies and enables the comparison of data on hundreds of risk factors, injuries and diseases, including lung cancer.
Guidelines for management of incidental pulmonary nodules detected on CT images
MacMahon et al. (2017)
International guidelines published by the Fleischner Society on the interpretation and clinical management of lung nodules detected incidentally during LDCT scans.
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International guidelines published by the Fleischner Society on the interpretation and clinical management of lung nodules detected incidentally during LDCT scans.
National Optimal Lung Cancer Pathway for suspected and confirmed lung cancer: Referral to treatment
NHS England (2020)
An infographic depicting a pathway designed to improve lung cancer outcomes by reducing variation and limiting delays in diagnosis, staging and treatment. NHS England recommends the pathway should be completed with reference to several guidelines for the management of lung cancer, providing examples of how this has been approached in the UK.
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An infographic depicting a pathway designed to improve lung cancer outcomes by reducing variation and limiting delays in diagnosis, staging and treatment. NHS England recommends the pathway should be completed with reference to several guidelines for the management of lung cancer, providing examples of how this has been approached in the UK.
Targeted screening for lung cancer with low radiation dose computed tomography: Quality assurance standards prepared for the Targeted Lung Health Checks programme
NHS England (2022)
Fifteen quality standards that together form the quality assurance framework for the national Targeted Lung Health Checks pilot programme. These standards apply to a range of areas across a screening programme, including: certification, experience and training of healthcare professionals; technical infrastructure, including data management and communications; imaging protocols and reporting; and onward referral for clinical management in secondary care settings.
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Fifteen quality standards that together form the quality assurance framework for the national Targeted Lung Health Checks pilot programme. These standards apply to a range of areas across a screening programme, including: certification, experience and training of healthcare professionals; technical infrastructure, including data management and communications; imaging protocols and reporting; and onward referral for clinical management in secondary care settings.
Management of pulmonary nodules
McNulty & Baldwin (2019)
A review of key concepts in the identification and management of lung nodules to balance the early detection and treatment of lung cancers against the potential harm and expense of over-investigation. The article also reviews the 2015 British Thoracic Society guidelines for the management of pulmonary nodules and the evidence behind them.
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A review of key concepts in the identification and management of lung nodules to balance the early detection and treatment of lung cancers against the potential harm and expense of over-investigation. The article also reviews the 2015 British Thoracic Society guidelines for the management of pulmonary nodules and the evidence behind them.
An exploration of the barriers to attendance at the English Stop Smoking Services
Kale et al. (2019)
A questionnaire of 672 participants in the Start2quit randomised controlled trial, which aimed to identify the most important barriers to the use of the English Stop Smoking Services. The findings suggest that many barriers exist and that they vary according to people's demographics and characteristics, pointing to the need for tailored recruitment strategies.
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A questionnaire of 672 participants in the Start2quit randomised controlled trial, which aimed to identify the most important barriers to the use of the English Stop Smoking Services. The findings suggest that many barriers exist and that they vary according to people's demographics and characteristics, pointing to the need for tailored recruitment strategies.
Cost-effectiveness analysis of lung cancer screening in the United States
Criss et al. (2019)
An economic evaluation of how eligibility criteria in guidelines for LDCT screening published by the United States Preventive Services Taskforce (USPSTF) and the Centers for Medicare & Medicaid Services (CMS) could be modified. The study precedes the recent updates to these guidelines in 2021 and 2022.
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An economic evaluation of how eligibility criteria in guidelines for LDCT screening published by the United States Preventive Services Taskforce (USPSTF) and the Centers for Medicare & Medicaid Services (CMS) could be modified. The study precedes the recent updates to these guidelines in 2021 and 2022.
Lung cancer screening economics and billing: Quick Reference Guide
American College of Radiology & National Lung Cancer Roundtable (2019)
A short guide providing answers to commonly asked questions around requirements for lung cancer screening programmes in the US, including logistics and billing.
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A short guide providing answers to commonly asked questions around requirements for lung cancer screening programmes in the US, including logistics and billing.
The route back to 25 by 25
UK Lung Cancer Coalition (2021)
A report for policymakers outlining the importance of implementing lung cancer screening and explaining how early detection may support the UK in recovering from the COVID-19 pandemic. It showcases infographics on the need for LDCT screening and case studies on how the Targeted Lung Health Checks model might help the UK get back on track to achieve the target of increasing five-year survival from lung cancer to 25% by 2025.
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A report for policymakers outlining the importance of implementing lung cancer screening and explaining how early detection may support the UK in recovering from the COVID-19 pandemic. It showcases infographics on the need for LDCT screening and case studies on how the Targeted Lung Health Checks model might help the UK get back on track to achieve the target of increasing five-year survival from lung cancer to 25% by 2025.
Lung Cancer Pathway Map
Cancer Care Ontario (2021)
The Lung Cancer Pathway Map comprises six different pathways tailored to various stages of the continuum of care for people with lung cancer, from screening to follow-up. The website provides visual examples of how each has been approached from a Canadian health system perspective.
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The Lung Cancer Pathway Map comprises six different pathways tailored to various stages of the continuum of care for people with lung cancer, from screening to follow-up. The website provides visual examples of how each has been approached from a Canadian health system perspective.
The OncoSim-Lung model
Canadian Partnership Against Cancer (2019)
A web-based cost/benefit analysis tool that helps researchers and decision-makers working in the areas of cancer prevention, screening and treatment to predict the impact of policy changes on various outcomes, including the economic burden of lung cancer.
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A web-based cost/benefit analysis tool that helps researchers and decision-makers working in the areas of cancer prevention, screening and treatment to predict the impact of policy changes on various outcomes, including the economic burden of lung cancer.
Resource utilization and costs during the initial years of lung cancer screening with computed tomography in Canada
Cressman et al. (2014)
A prospective analysis of the Pan-Canadian Early Detection of Lung Cancer study designed to improve the evidence base for cost-effectiveness modeling studies on LDCT lung cancer screening.
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A prospective analysis of the Pan-Canadian Early Detection of Lung Cancer study designed to improve the evidence base for cost-effectiveness modeling studies on LDCT lung cancer screening.
Lung cancer screening: who pays? who receives? – the Chinese perspective
Zhang & Cheng (2021)
A review of areas of implementation that need to be considered when planning to introduce targeted LDCT screening in a non-Western context, such as China.
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A review of areas of implementation that need to be considered when planning to introduce targeted LDCT screening in a non-Western context, such as China.
The value of lung cancer CT screening: it is all about implementation
Goulart (2015)
A review of current reimbursement policies for LDCT screening and the relationship between implementation strategies and value using data from the National Lung Screening Trial. The review also explores areas of inefficiency that could arise during implementation and offers potential solutions.
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A review of current reimbursement policies for LDCT screening and the relationship between implementation strategies and value using data from the National Lung Screening Trial. The review also explores areas of inefficiency that could arise during implementation and offers potential solutions.
Business case to improve access to smoking cessation medications in Canada
Canadian Partnership Against Cancer (2021)
A report outlining recommendations on how to build a business case for smoking cessation services targeting people with cancer, which includes ensuring access for people who are considered eligible for lung cancer screening.
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A report outlining recommendations on how to build a business case for smoking cessation services targeting people with cancer, which includes ensuring access for people who are considered eligible for lung cancer screening.
Budget impact analysis of cancer screening: A methodological review
Jahn et al. (2019)
A systematic review assessing how closely methodological guidelines for budget impact analyses are followed when this type of economic evaluation is performed for cancer screening programmes, including lung cancer ones.
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A systematic review assessing how closely methodological guidelines for budget impact analyses are followed when this type of economic evaluation is performed for cancer screening programmes, including lung cancer ones.
Screen Your Lungs
American Cancer Society, GO2 Foundation, LUNGevity, National Lung Cancer Roundtable (N/A)
An online decision aid for potential participants of a lung cancer screening programme. Offered by the American Cancer Society, the GO2 Foundation, LUNGevity and the National Lung Cancer Roundtable, the website offers an interactive quiz that allows people to check whether they might be eligible for LDCT screening. It also directs them to further resources that provide information on lung cancer, making an appointment, smoking cessation and insurance coverage.
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An online decision aid for potential participants of a lung cancer screening programme. Offered by the American Cancer Society, the GO2 Foundation, LUNGevity and the National Lung Cancer Roundtable, the website offers an interactive quiz that allows people to check whether they might be eligible for LDCT screening. It also directs them to further resources that provide information on lung cancer, making an appointment, smoking cessation and insurance coverage.
Projections of lung cancer incidence by 2035 in 40 countries worldwide: population-based study
Luo et al. (2023)
A modelling study that aimed to predict the incidence of lung cancer by 2035 across 40 countries, with an emphasis on country- and sex-specific disparities.
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A modelling study that aimed to predict the incidence of lung cancer by 2035 across 40 countries, with an emphasis on country- and sex-specific disparities.
Lung cancer screening: NCCN guidelines for patients
National Comprehensive Cancer Network (2020)
An overview of the benefits and harms of LDCT screening, which may be used to support an individual's decision to take part in a screening programme in the US. The report also provides a more detailed breakdown of key terms and steps across the lung cancer care continuum should lung cancer be detected during screening.
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An overview of the benefits and harms of LDCT screening, which may be used to support an individual's decision to take part in a screening programme in the US. The report also provides a more detailed breakdown of key terms and steps across the lung cancer care continuum should lung cancer be detected during screening.
Targeted screening for lung cancer with low radiation dose computed tomography: Standard protocol prepared for the Targeted Lung Health Checks Programme
NHS England (2022)
The protocol for lung cancer screening for all sites participating in the Targeted Lung Health Checks pilot programme. The protocol aims to ensure a consistent and equitable approach to the provision and monitoring of targeted screening for lung cancer across England.
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The protocol for lung cancer screening for all sites participating in the Targeted Lung Health Checks pilot programme. The protocol aims to ensure a consistent and equitable approach to the provision and monitoring of targeted screening for lung cancer across England.
BTS guidelines for the investigation and management of pulmonary nodules
British Thoracic Society (2015)
Guidelines for the investigation and management of lung nodules, drawing on a comprehensive review of the evidence and expert consensus. Recommendations are provided for multiple points along the care pathway, including screening, follow-up imaging for diagnosis and onward referral for clinical management.
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Guidelines for the investigation and management of lung nodules, drawing on a comprehensive review of the evidence and expert consensus. Recommendations are provided for multiple points along the care pathway, including screening, follow-up imaging for diagnosis and onward referral for clinical management.
LungPLAN
American Cancer Society & the National Lung Cancer Roundtable (2021)
An Excel-based financial forecasting tool that can be used to model the resources required to implement screening programmes and their downstream economic impact. LungPLAN is accompanied by training resources, including a user manual and step-by-step training videos.
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An Excel-based financial forecasting tool that can be used to model the resources required to implement screening programmes and their downstream economic impact. LungPLAN is accompanied by training resources, including a user manual and step-by-step training videos.
Risk-based NLST Outcomes Tool (RNOT)
National Cancer Institute (N/A)
A risk prediction model that uses smoking history and data collected from the National Lung Cancer Screening Trial (NLST) to estimate an individual’s risk of getting or dying from lung cancer in the next five years and the likelihood of them getting a false-positive test result. It also helps users understand whether they might be recommended to get lung cancer screening based on criteria set out by the US Preventive Services Task Force.
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A risk prediction model that uses smoking history and data collected from the National Lung Cancer Screening Trial (NLST) to estimate an individual’s risk of getting or dying from lung cancer in the next five years and the likelihood of them getting a false-positive test result. It also helps users understand whether they might be recommended to get lung cancer screening based on criteria set out by the US Preventive Services Task Force.
Bach model: the 1-year probability of lung cancer diagnosis
Bach et al. (N/A)
An online calculator for the Bach risk prediction model, which estimates the probability of being diagnosed with lung cancer within the next year. The model was developed based on the Carotene and Retinol Efficacy Trial (CARET) – a large, randomized trial of lung cancer prevention.
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An online calculator for the Bach risk prediction model, which estimates the probability of being diagnosed with lung cancer within the next year. The model was developed based on the Carotene and Retinol Efficacy Trial (CARET) – a large, randomized trial of lung cancer prevention.
Interventions designed to increase the uptake of lung cancer screening: an equity-oriented scoping review
Sayani et al. (2023)
A global review of approaches to reducing barriers to lung cancer screening. The findings were used to update a conceptual framework for addressing inequitable health outcomes across the lung cancer care pathway, which may support users during the implementation of screening programmes.
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A global review of approaches to reducing barriers to lung cancer screening. The findings were used to update a conceptual framework for addressing inequitable health outcomes across the lung cancer care pathway, which may support users during the implementation of screening programmes.
Toward equity‑oriented cancer care: a Strategy for Patient‑Oriented Research (SPOR) protocol to promote equitable access to lung cancer screening
Sayani et al. (2022)
A protocol for an equity-informed research study aiming to promote equitable access to lung cancer screening programmes by working with patients to co-design an e-learning module for healthcare providers. The study explores how patient engagement in research can promote the delivery of accessible and acceptable health services, including lung cancer screening.
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A protocol for an equity-informed research study aiming to promote equitable access to lung cancer screening programmes by working with patients to co-design an e-learning module for healthcare providers. The study explores how patient engagement in research can promote the delivery of accessible and acceptable health services, including lung cancer screening.
Bridging the gap: The challenge of mitigating health inequalities in lung cancer
The UK Lung Cancer Coalition (2022)
A set of recommendations that aim to ensure that all people with lung cancer, regardless of individual differences, have equitable access to diagnosis, treatment and care. One of the recommendations listed is the introduction of a national screening programme.
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A set of recommendations that aim to ensure that all people with lung cancer, regardless of individual differences, have equitable access to diagnosis, treatment and care. One of the recommendations listed is the introduction of a national screening programme.
Saved By The Scan
American Lung Association (N/A)
An online decision-aid designed in the form of a quiz for the general public to better understand whether they might be eligible for lung cancer screening.
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An online decision-aid designed in the form of a quiz for the general public to better understand whether they might be eligible for lung cancer screening.
Risk-based lung cancer screening: a systematic review
Toumazis et al. (2020)
Overview of different screening models, considering the risk factors used, the target population and the strength of evidence for each model.
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Overview of different screening models, considering the risk factors used, the target population and the strength of evidence for each model.
Lung cancer risk calculators (PLCO)
Brock University (N/A)
A website offering downloadable Excel-based risk prediction models based on the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO). The PLCO models may be used to estimate an individual’s probability of developing lung cancer over six years and determine their eligibility for screening. Various mobile phone apps for the risk prediction models are also available to download elsewhere (e.g. Apple and Android).
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A website offering downloadable Excel-based risk prediction models based on the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO). The PLCO models may be used to estimate an individual’s probability of developing lung cancer over six years and determine their eligibility for screening. Various mobile phone apps for the risk prediction models are also available to download elsewhere (e.g. Apple and Android).
Implications of 9 risk prediction models for selecting ever smokers for CT lung-cancer screening
Katki et al. (2018)
A study that examined which risk prediction models most accurately predict an individual's risk of lung cancer and which perform best in selecting people who have ever smoked for LDCT screening using a data set drawn from the US population.
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A study that examined which risk prediction models most accurately predict an individual's risk of lung cancer and which perform best in selecting people who have ever smoked for LDCT screening using a data set drawn from the US population.
MyLungRisk: Liverpool Lung Project (LLP) risk model
Roy Castle Lung Cancer Foundation (2019)
A web-based questionnaire that may be used to calculate an individual’s risk of developing lung cancer over the next five years based on the second version of the Liverpool Lung Project model (LLPv2). The LLPv2 is currently applied in the UK Targeted Lung Health Checks pilot programme, although the LLPv3 is also available.
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A web-based questionnaire that may be used to calculate an individual’s risk of developing lung cancer over the next five years based on the second version of the Liverpool Lung Project model (LLPv2). The LLPv2 is currently applied in the UK Targeted Lung Health Checks pilot programme, although the LLPv3 is also available.
Attitudes towards lung cancer screening in a population sample
Smits et al. (2018)
A study exploring potential barriers to uptake of lung cancer screening following a population-based survey in Wales (UK). Importantly, the results suggest that personal beliefs around lung cancer could be a barrier to uptake in this population. The study authors outline recommended approaches to address this ahead of implementation.
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A study exploring potential barriers to uptake of lung cancer screening following a population-based survey in Wales (UK). Importantly, the results suggest that personal beliefs around lung cancer could be a barrier to uptake in this population. The study authors outline recommended approaches to address this ahead of implementation.
Lung cancer screening CT protocols (version 5.1)
American Association of Physicists in Medicine (2019)
A summary of protocols developed by the American Association of Physicists in Medicine's Working Group on Standardization of CT Nomenclature and Protocols for lung cancer screening. These protocols were based in part on manufacturers’ protocols, but they were adapted according to the Working Group’s experience with the National Lung Screening Trial and other screening studies.
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A summary of protocols developed by the American Association of Physicists in Medicine's Working Group on Standardization of CT Nomenclature and Protocols for lung cancer screening. These protocols were based in part on manufacturers’ protocols, but they were adapted according to the Working Group’s experience with the National Lung Screening Trial and other screening studies.
Establishing scanning protocols for a CT lung cancer screening trial in the UK
Iball et al. (2021)
A review of different resources and guidance relating to CT acquisition protocols for lung cancer screening, which were used to inform the development of a protocol for the Yorkshire Lung Screening Trial.
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A review of different resources and guidance relating to CT acquisition protocols for lung cancer screening, which were used to inform the development of a protocol for the Yorkshire Lung Screening Trial.
Management of screen-detected lung nodules: A Canadian Partnership Against Cancer guidance document
Lam et al. (2020)
The Canadian Partnership Against Cancer and the Pan-Canadian Lung Cancer Screening Network undertook a scientific review of the assessment and management of lung nodules detected via LDCT screening to provide consensus-based guidance on setting up a protocol for lung cancer screening.
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The Canadian Partnership Against Cancer and the Pan-Canadian Lung Cancer Screening Network undertook a scientific review of the assessment and management of lung nodules detected via LDCT screening to provide consensus-based guidance on setting up a protocol for lung cancer screening.
Lung Nodule Profile Calculator (v0.2)
Quantitative Imaging Biomarkers Alliance (2018)
An online prototype of a tool for estimating the risk of a solid nodule detected during lung cancer screening being cancer. Also known as nodule risk models, these type of tools are designed to support evaluation of results from LDCT screening and clinical decision-making.
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An online prototype of a tool for estimating the risk of a solid nodule detected during lung cancer screening being cancer. Also known as nodule risk models, these type of tools are designed to support evaluation of results from LDCT screening and clinical decision-making.
Latest CT technologies in lung cancer screening: protocols and radiation dose reduction
Vonder et al. (2021)
A review that explores different guidelines and CT acquisition protocols for LDCT screening, as well as new areas of development, such as AI and other techniques to improve the quality of screening and reduce the radiation dose.
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A review that explores different guidelines and CT acquisition protocols for LDCT screening, as well as new areas of development, such as AI and other techniques to improve the quality of screening and reduce the radiation dose.
I-ELCAP protocols
International Early Lung Cancer Action Program (N/A)
The International Early Lung Cancer Action Program (I-ELCAP) demonstrated that a consistent screening protocol and techniques may be applied globally to achieve high-quality results from lung cancer screening. The website offers a downloadable version of the latest I-ELCAP protocol, including criteria and procedures for facilities taking part in I-ELCAP research, screening and follow-up procedures (e.g. for pathology).
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The International Early Lung Cancer Action Program (I-ELCAP) demonstrated that a consistent screening protocol and techniques may be applied globally to achieve high-quality results from lung cancer screening. The website offers a downloadable version of the latest I-ELCAP protocol, including criteria and procedures for facilities taking part in I-ELCAP research, screening and follow-up procedures (e.g. for pathology).
NCCN Guidelines Insights: Lung cancer screening Version 1.2022
National Comprehensive Cancer Network (2022)
An article summarising the 2022 guidelines for lung cancer screening from the US-based National Comprehensive Cancer Network, the updated version of which can be found here. The article provides several infographics to clarify the pathways for conducting an eligibility assessment on participants, evaluating the results from LDCT screening and following up with participants.
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An article summarising the 2022 guidelines for lung cancer screening from the US-based National Comprehensive Cancer Network, the updated version of which can be found here. The article provides several infographics to clarify the pathways for conducting an eligibility assessment on participants, evaluating the results from LDCT screening and following up with participants.
ACRIN Protocol #6654. Contemporary screening for the detection of lung cancer
American College of Radiology Image Network (2004)
The original protocol for the landmark randomised controlled National Lung Screen Trial (NLST) in the US. The Case Report Form Set for the NLST is also available separately.
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The original protocol for the landmark randomised controlled National Lung Screen Trial (NLST) in the US. The Case Report Form Set for the NLST is also available separately.
Rapid referral pathways: reducing delays in the diagnosis of lung cancer
All.Can (N/A)
An online article exploring specific examples of how the implementation of rapid referral pathway interventions has improved health outcomes for people diagnosed with lung cancer, either incidentally or through screening programmes.
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An online article exploring specific examples of how the implementation of rapid referral pathway interventions has improved health outcomes for people diagnosed with lung cancer, either incidentally or through screening programmes.
Canadian Partnership Against Cancer
Canadian Partnership Against Cancer (2021)
Resources that aim to support jurisdictions across Canada in embedding and delivering comprehensive, evidence-based smoking cessation programmes in cancer care settings. They include a pan-Canadian smoking cessation action framework and an accompanying implementation checklist.
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Resources that aim to support jurisdictions across Canada in embedding and delivering comprehensive, evidence-based smoking cessation programmes in cancer care settings. They include a pan-Canadian smoking cessation action framework and an accompanying implementation checklist.
Lung CT Screening Reporting & Data System (Lung-RADS v2022)
American College of Radiology (2022)
Lung-RADS is a structured reporting system designed to standardise the interpretation of results from LDCT lung cancer screening. Commonly referred to as a nodule management protocol, it is also designed to better facilitate monitoring of outcomes from screening and provide recommendations for the clinical management of any lung nodules detected via LDCT.
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Lung-RADS is a structured reporting system designed to standardise the interpretation of results from LDCT lung cancer screening. Commonly referred to as a nodule management protocol, it is also designed to better facilitate monitoring of outcomes from screening and provide recommendations for the clinical management of any lung nodules detected via LDCT.
Lung Cancer Screening Registry measures
American College of Radiology (2023)
The definitions, including numerators and denominators, for performance indicators used by the US Lung Cancer Screening Registry (LCSR). Managed by the US National Radiology Data Registry, the document may help users learn how a screening registry could be set up and which data are reported from lung cancer screening programmes in the US. Associated resources, such as a data dictionary and template upload form, are available on the LCSR webpage.
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The definitions, including numerators and denominators, for performance indicators used by the US Lung Cancer Screening Registry (LCSR). Managed by the US National Radiology Data Registry, the document may help users learn how a screening registry could be set up and which data are reported from lung cancer screening programmes in the US. Associated resources, such as a data dictionary and template upload form, are available on the LCSR webpage.
Optimal care pathway for people with lung cancer (second edition)
Cancer Council Australia (2021)
A report outlining seven key steps in optimising care for people with lung cancer in Australia. Each step outlines nationally agreed best-practice recommendations for developing a lung cancer care pathway, including definitions, checklists and examples of healthcare professionals required to ensure that all the needs of people with lung cancer are sufficiently met.
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A report outlining seven key steps in optimising care for people with lung cancer in Australia. Each step outlines nationally agreed best-practice recommendations for developing a lung cancer care pathway, including definitions, checklists and examples of healthcare professionals required to ensure that all the needs of people with lung cancer are sufficiently met.
National Disease Registration Service
NHS Digital (N/A)
This guidance explains why information about cancer patients is recorded by the National Cancer Registration and Analysis Service, how it is used and how patients can opt out of registration.
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This guidance explains why information about cancer patients is recorded by the National Cancer Registration and Analysis Service, how it is used and how patients can opt out of registration.
Towards better implementation of cancer screening in Europe through improved monitoring and evaluation and greater engagement of cancer registries
Anttila et al. (2015)
An article outlining the EUROCOURSE project, which aims to improve the implementation, monitoring and evaluation of breast, cervical and colorectal cancer screening programmes. The article discusses cancer registration and recommended performance indicators that may offer learning applicable to lung cancer screening.
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An article outlining the EUROCOURSE project, which aims to improve the implementation, monitoring and evaluation of breast, cervical and colorectal cancer screening programmes. The article discusses cancer registration and recommended performance indicators that may offer learning applicable to lung cancer screening.
The Cancer Screening in Five Continents project (CanScreen5)
International Agency for Research on Cancer (N/A)
An initiative that aims to collect information on breast, cervical and colorectal cancer screening programmes across the globe and assist countries in organising their health information systems. The core objective of CanScreen5 is to support countries in collecting screening data for effective programme evaluation and quality improvement. Some of the key learnings may also be applicable to lung cancer screening.
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An initiative that aims to collect information on breast, cervical and colorectal cancer screening programmes across the globe and assist countries in organising their health information systems. The core objective of CanScreen5 is to support countries in collecting screening data for effective programme evaluation and quality improvement. Some of the key learnings may also be applicable to lung cancer screening.
Lung cancer screening center designation
American College of Radiology (ACR) (2022)
Technical requirements for designation as an ACR-accredited lung cancer screening center in the US.
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Technical requirements for designation as an ACR-accredited lung cancer screening center in the US.
NHS Cancer Programme: An introduction to approaches to evaluation
Public Health England (2022)
A report compiled by NHS England and NHS Improvement that introduces the key methodological approaches to undertaking an evaluation of cancer control programmes. The report signposts users to examples of data collection and templates, such as guidance on how to develop a Theory of Change and apply logic models for cancer screening.
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A report compiled by NHS England and NHS Improvement that introduces the key methodological approaches to undertaking an evaluation of cancer control programmes. The report signposts users to examples of data collection and templates, such as guidance on how to develop a Theory of Change and apply logic models for cancer screening.
Low-dose CT for lung cancer screening: position paper from the Italian College of Thoracic Radiology
Silva et al. (2022)
An article providing introductory guidance for radiologists who plan to set up or be involved in lung cancer screening in Italy. The position statement aims to foster a standardised and evidence-based approach to LDCT screening across Italy and to enable comparison with practices adopted in other countries.
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An article providing introductory guidance for radiologists who plan to set up or be involved in lung cancer screening in Italy. The position statement aims to foster a standardised and evidence-based approach to LDCT screening across Italy and to enable comparison with practices adopted in other countries.
The evaluation of cancer screening: concepts and outcome measures
Duffy & Smith (2020)
A review exploring key concepts for evaluating cancer screening and practical considerations around monitoring a programme for quality improvement. The article draws on case studies for its recommendations, including learning from implementation research of LDCT lung cancer screening.
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A review exploring key concepts for evaluating cancer screening and practical considerations around monitoring a programme for quality improvement. The article draws on case studies for its recommendations, including learning from implementation research of LDCT lung cancer screening.
Lung cancer: diagnosis and management guidance
National Institute for Health and Care Excellence (2023)
The most recent guidance for the diagnosis and management of lung cancer published by the UK National Institute for Health and Care Excellence (NICE). The guidance is for healthcare professionals, commissioners and people living with lung cancer. It offers specific recommendations around access to services, communication, diagnosis and staging, treatment, follow-up and palliative care.
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The most recent guidance for the diagnosis and management of lung cancer published by the UK National Institute for Health and Care Excellence (NICE). The guidance is for healthcare professionals, commissioners and people living with lung cancer. It offers specific recommendations around access to services, communication, diagnosis and staging, treatment, follow-up and palliative care.
Implementation and organization of lung cancer screening
Pedersen & Ashraf (2016)
A brief review of the implementation status of LDCT screening programmes and the hurdles to overcome in the future. The article also describes the guidelines and requirements for the structure and components of high-quality CT screening programmes.
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A brief review of the implementation status of LDCT screening programmes and the hurdles to overcome in the future. The article also describes the guidelines and requirements for the structure and components of high-quality CT screening programmes.
Targeted screening for lung cancer in individuals at increased risk: External review against programme appraisal criteria for the UK National Screening Committee
UK National Screening Committee (NSC) (2022)
A summary of the evidence that the UK NSC considered when forming the recommendation that targeted LDCT screening for lung cancer should be introduced. It assesses evidence around lung cancer published up until June 2021 to answer five primary questions.
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A summary of the evidence that the UK NSC considered when forming the recommendation that targeted LDCT screening for lung cancer should be introduced. It assesses evidence around lung cancer published up until June 2021 to answer five primary questions.
Adult screening programme: Lung cancer recommendation
UK National Screening Committee (2022)
The updated recommendation from the UK National Screening Committee published in June 2022. The statement now recommends that the four nations within the UK move towards the implementation of targeted lung cancer screening with integrated smoking cessation services, using the Targeted Lung Health Checks pilot programme as 'a feasible and effective starting point for implementation in England'.
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The updated recommendation from the UK National Screening Committee published in June 2022. The statement now recommends that the four nations within the UK move towards the implementation of targeted lung cancer screening with integrated smoking cessation services, using the Targeted Lung Health Checks pilot programme as 'a feasible and effective starting point for implementation in England'.
Clinician summary of USPSTF recommendations for lung cancer screening
US Preventive Services Task Force (2021)
The most recent update of national guidelines around how to implement LDCT screening within the US, including a summary of the evidence base for the decision.
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The most recent update of national guidelines around how to implement LDCT screening within the US, including a summary of the evidence base for the decision.
The International Cancer Control Partnership Portal
International Cancer Control Partnership (N/A)
An online resource hub for the development, implementation and evaluation of national cancer control plans. Provided by a group of organisations affiliated with the Union for International Cancer Control, the portal offers resources for across the cancer care continuum, including technical assistance, thematic toolkits and an interactive map of national strategies.
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An online resource hub for the development, implementation and evaluation of national cancer control plans. Provided by a group of organisations affiliated with the Union for International Cancer Control, the portal offers resources for across the cancer care continuum, including technical assistance, thematic toolkits and an interactive map of national strategies.
Implementation guide for lung cancer screening
American Thoracic Society and American Lung Association (2018)
A comprehensive report developed to provide practical guidance on how to implement lung cancer screening, with a focus on the US. The report is also presented as a digital resource that has dedicated web pages for each section with accompanying resources.
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A comprehensive report developed to provide practical guidance on how to implement lung cancer screening, with a focus on the US. The report is also presented as a digital resource that has dedicated web pages for each section with accompanying resources.
Implementation planning guide for programmatic lung cancer screening: Readiness assessment toolkit (Version 1.0, March 2020).
Canadian Partnership Against Cancer (2020)
A toolkit for Canadian jurisdictions to understand their readiness to implement an organised LDCT lung cancer screening programme. The toolkit, offered as a template download, comprises a series of structured questions specific to the Canadian policy context to assess local capacity to implement and evaluate a screening programme across six domains.
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A toolkit for Canadian jurisdictions to understand their readiness to implement an organised LDCT lung cancer screening programme. The toolkit, offered as a template download, comprises a series of structured questions specific to the Canadian policy context to assess local capacity to implement and evaluate a screening programme across six domains.
Early diagnosis matters: Making the case for the early and rapid diagnosis of lung cancer
UK Lung Cancer Coalition (2020)
A report exploring the case for diagnosing lung cancer earlier via screening or other types of intervention. This includes specific examples of how implementation of a national screening programme in England could support earlier diagnosis of lung cancer.
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A report exploring the case for diagnosing lung cancer earlier via screening or other types of intervention. This includes specific examples of how implementation of a national screening programme in England could support earlier diagnosis of lung cancer.
Contemporary issues in the implementation of lung cancer screening
Lam & Tammemagi (2021)
An overview of several areas across a lung cancer screening programme that require optimisation, including smoking cessation and nodule management. The paper also demonstrates how an organised programme might be structured from a Canadian health system perspective.
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An overview of several areas across a lung cancer screening programme that require optimisation, including smoking cessation and nodule management. The paper also demonstrates how an organised programme might be structured from a Canadian health system perspective.
9th edition of the TNM classification for thoracic cancers (IASLC Staging Project)
International Association for the Study of Lung Cancer (2021)
An international project inviting data submission by health systems or individual programmes collecting information on the stage at which lung cancer is diagnosed within their populations. The project aims to advocate for optimal clinical management of lung cancer by providing recommendations on how to improve and standardise the nodule classification system for diagnosis.
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An international project inviting data submission by health systems or individual programmes collecting information on the stage at which lung cancer is diagnosed within their populations. The project aims to advocate for optimal clinical management of lung cancer by providing recommendations on how to improve and standardise the nodule classification system for diagnosis.
Reduced lung cancer mortality with low-dose computed tomographic screening
The National Lung Screening Trial Research Team (2011)
The landmark National Lung Screening Trial (NLST) demonstrated a 20% reduction in lung cancer mortality among those who underwent LDCT screening compared with annual chest X-rays. Results from the NLST also supported the development of national guidelines for LDCT screening in the US.
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The landmark National Lung Screening Trial (NLST) demonstrated a 20% reduction in lung cancer mortality among those who underwent LDCT screening compared with annual chest X-rays. Results from the NLST also supported the development of national guidelines for LDCT screening in the US.
Considerations to ensure optimum roll-out of targeted lung cancer screening over the next five years
British Society of Thoracic Imaging and the Royal College of Radiologists (2020)
A position paper from professional societies in the UK outlining their specific recommendations on how to optimise the implementation of the Targeted Lung Health Checks programme in England, particularly when developing protocols for CT acquisition and nodule management.
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A position paper from professional societies in the UK outlining their specific recommendations on how to optimise the implementation of the Targeted Lung Health Checks programme in England, particularly when developing protocols for CT acquisition and nodule management.
Lung cancer screening with low dose computed tomography: Guidelines for business case development
Canadian Partnership Against Cancer (2020)
A report outlining a proposed business case for LDCT screening, which jurisdictions can adapt and use in their own provincial or territorial contexts to advance implementation in Canada. A readiness assessment toolkit has also been created as a complementary resource to support partners in using the business case.
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A report outlining a proposed business case for LDCT screening, which jurisdictions can adapt and use in their own provincial or territorial contexts to advance implementation in Canada. A readiness assessment toolkit has also been created as a complementary resource to support partners in using the business case.
Plan and deliver a cancer screening project
Cancer Council Victoria (N/A)
An online toolkit to support researchers in designing cancer screening programmes with communities. It includes guidance on how to conduct a needs assessment, principles and methods for co-production, budget requirements for community engagement and an introductory module on how to evaluate a screening programme.
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An online toolkit to support researchers in designing cancer screening programmes with communities. It includes guidance on how to conduct a needs assessment, principles and methods for co-production, budget requirements for community engagement and an introductory module on how to evaluate a screening programme.
Policy, evidence and practice for screening programmes
UK National Screening Committee (2022)
A manual explaining the evidence base and core components for implementing screening programmes aimed at stakeholders across the UK health system. It offers chapters on the principles of population screening and requirements that span several domains of the Network's framework, including considerations for workforce capacity and data management for screening programmes.
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A manual explaining the evidence base and core components for implementing screening programmes aimed at stakeholders across the UK health system. It offers chapters on the principles of population screening and requirements that span several domains of the Network's framework, including considerations for workforce capacity and data management for screening programmes.
Example models for structuring a screening programme
GO2 for Lung Cancer (N/A)
Examples of centralised, decentralised and hybrid models for organised lung cancer screening and how they might operate in the US health system.
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Examples of centralised, decentralised and hybrid models for organised lung cancer screening and how they might operate in the US health system.
Lung cancer screening implementation guide: programme structure guidance
American Thoracic Society and American Lung Association (2019)
Similar to the infographics produced by GO2 for Lung Cancer, this webpage provides examples of centralised, decentralised and hybrid models for organised lung cancer screening from a US health system perspective.
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Similar to the infographics produced by GO2 for Lung Cancer, this webpage provides examples of centralised, decentralised and hybrid models for organised lung cancer screening from a US health system perspective.
The economic burden of cancer in Canada from a societal perspective
Garaszczuk et al. (2022)
An article exploring the economic burden of cancer and potential applications of the OncoSim-All Cancers model to estimate the direct, indirect and total healthcare costs of lung cancer in 2021.
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An article exploring the economic burden of cancer and potential applications of the OncoSim-All Cancers model to estimate the direct, indirect and total healthcare costs of lung cancer in 2021.
Lung cancer screening by low-dose computed tomography: a cost-effectiveness analysis of alternative programmes in the UK using a newly developed natural history-based economic model
Griffin et al. (2020)
A cost-effectiveness analysis of lung cancer screening in the UK that seeks to compare the projected downstream financial impact of introducing screening under 48 different conditions, including at different intervals (e.g. single scan, annual or biennial).
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A cost-effectiveness analysis of lung cancer screening in the UK that seeks to compare the projected downstream financial impact of introducing screening under 48 different conditions, including at different intervals (e.g. single scan, annual or biennial).
Projected clinical, resource use, and fiscal impacts of implementing low-dose computed tomography lung cancer screening in Medicare
Roth et al. (2015)
A comparative study modelling the impact of different areas of the Centers for Medicare & Medicaid Services (CMS) policy on LDCT screening in the US. The findings may help support stakeholders involved in planning and implementing lung cancer screening programmes.
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A comparative study modelling the impact of different areas of the Centers for Medicare & Medicaid Services (CMS) policy on LDCT screening in the US. The findings may help support stakeholders involved in planning and implementing lung cancer screening programmes.
Report on the Lung Cancer Screening enquiry
Cancer Australia (2020)
A report outlining the findings of an enquiry into a national lung cancer screening programme in Australia. It includes national and international evidence on lung cancer screening, information on the best design for a screening programme within the policy context and an overview of the mechanics behind the effective delivery of a lung cancer screening programme.
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A report outlining the findings of an enquiry into a national lung cancer screening programme in Australia. It includes national and international evidence on lung cancer screening, information on the best design for a screening programme within the policy context and an overview of the mechanics behind the effective delivery of a lung cancer screening programme.
Recommendation for lung cancer screening by the Centers for Medicare & Medicaid Services
Centers for Medicare & Medicaid Services (2022)
A decision memo from the Centers for Medicare & Medicaid Services that recommends expanding the coverage of lung cancer screening in the US. The memo outlines the decision-making process, including the evidence base for screening, updated eligibility criteria and requirements for individual providers of LDCT screening.
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A decision memo from the Centers for Medicare & Medicaid Services that recommends expanding the coverage of lung cancer screening in the US. The memo outlines the decision-making process, including the evidence base for screening, updated eligibility criteria and requirements for individual providers of LDCT screening.
Treatment capacity required for full-scale implementation of lung cancer screening in the United States
Blom et al. (2019)
A study to assess and model the technical and workforce capacity required for treating lung cancer using data from the National Cancer Database. The results suggested that gradually scaling up a programme would spread the increase in demand for surgery over time, although careful planning is essential for successful implementation.
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A study to assess and model the technical and workforce capacity required for treating lung cancer using data from the National Cancer Database. The results suggested that gradually scaling up a programme would spread the increase in demand for surgery over time, although careful planning is essential for successful implementation.
Lung cancer screening in Canada: 2021/2022
Canadian Partnership Against Cancer (2021/2022)
An environmental scan of data collected from provincial and territorial lung cancer screening programmes in 2021. Disseminated as an online report, it seeks to provide an overview of the status of lung cancer screening. It notes the programmes, implementation research and rapid diagnosis initiatives in each province and provides details on how implementation is being approached to inform decision-making. An earlier version for 2019/2020 is also available.
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An environmental scan of data collected from provincial and territorial lung cancer screening programmes in 2021. Disseminated as an online report, it seeks to provide an overview of the status of lung cancer screening. It notes the programmes, implementation research and rapid diagnosis initiatives in each province and provides details on how implementation is being approached to inform decision-making. An earlier version for 2019/2020 is also available.