This interactive map showcases both examples of low-dose computed tomography (LDCT) screening implementation and an overview of the current status of early detection via LDCT screening for lung cancer around the world.
The aim of the map is to facilitate the sharing of best practice and to guide policy development around the use of LDCT screening to detect lung cancer. It is designed to be a comprehensive resource that collates ongoing and completed implementation research for LCDT screening globally.
The map can be used by researchers, patient advocates and policymakers to support policy discussions around the status of and evidence for detecting lung cancer earlier. It can also facilitate data sharing between different stakeholders – case studies from the map can inform and promote the implementation of LDCT screening in new locations.
A summary of the methodology used to create this map is outlined below. The full methodology, including the search strategy, is available to download.
What questions could the interactive map be used to answer?
This is, to our knowledge, the first global database of LDCT screening implementation research. Analysis of data will enable users to answer key questions surrounding implementation, including:
- Which countries have formally committed to implementing organised LDCT lung cancer screening programmes?
- What recruitment methods are being used to try to optimise attendance, particularly in populations at highest risk of lung cancer?
- What outcomes from screening have been reported, for example the proportion of participants diagnosed with early-stage lung cancer? How do these align with published clinical trial evidence?
The answers to these questions may help inform best practice for LDCT screening and highlight important contextual factors around implementation.
Development of the interactive map
A rapid review of the literature was used to identify a preliminary list of studies/programmes to include in the map. This list was reviewed by members of the Lung Cancer Policy Network, who guided the development of a specific research methodology to determine variables for inclusion in the map, in which clinical trials were also later included.
Following the methodology, a global scoping review of peer-reviewed and grey literature was undertaken to collate information for each study/programme identified. Where possible, completed entries were sent to the study or programme lead to ensure data collected were accurate and up to date.
The first edition of the map only includes ongoing or recently completed trials, studies or programmes that ended since 2015. A second edition will also cover initiatives that ended during or since 2010, as well as research in the US. The contents of the map will be updated twice a year.
Definitions of trials, studies and programmes applied to the interactive map
A randomised controlled trial (RCT) that seeks to assess whether LDCT screening is more effective at reducing mortality or all-cause mortality than a control intervention, such as non-LDCT screening or usual care.
A study that focuses on exploring the implementation of LDCT screening in a real-world context. Examples include implementation trials, feasibility studies or the preliminary roll-out of an organised programme at designated sites or geographical regions (pilots). Although these terms may be used interchangeably and definitions vary, these studies tend to share common research objectives around the implementation of lung cancer screening.
National or regional programme
A formally endorsed and organised national- or regional-level LDCT lung cancer screening programme.
Eligibility criteria for the map
- Clinical trials, implementation studies or regional/national programmes.
- The study/programme is investigating the implementation of LDCT for early detection of lung cancer.
- The specific population group(s) targeted are asymptomatic individuals considered to be at high risk of developing lung cancer, taking into account potential local variation in risk factors and screening protocols used.
- For regional and national programmes, only LDCT screening investigated as part of an organised programme is included; we have not looked at any programmes that use opportunistic LDCT screening.
- For the first edition of the map, we have included only ongoing or recently completed studies/programmes (ending after 1 January 2015) that focus solely on LDCT. The second edition of the map will also expand the coverage of the United States.
- Studies/programmes with a primary objective that is not related to implementation of LDCT screening (e.g. smoking cessation studies that look at LDCT only as a secondary objective; cost-effectiveness studies of LDCT screening).
- Studies/programmes that focus on the investigation of non-LDCT to lung cancer screening (e.g. chest X-ray, conventional computed tomography).
- Implementation of opportunistic LDCT screening for lung cancer outside of an organised programme.