This interactive map showcases examples of low-dose computed tomography (LDCT) screening implementation and provides an overview of the current status of early detection of lung cancer via LDCT screening in each country.
The aims of the map are to provide helpful information to countries that are considering the implementation of LDCT lung cancer screening and to facilitate the sharing of lessons learnt, including from countries that have already established screening programmes.
The map can be used as evidence to support policy discussions around implementing LDCT screening to increase the early detection of lung cancer. It can also facilitate data sharing between different stakeholders to inform and promote implementation 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 for lung cancer. Analysis of the 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 among 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 scoping 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 the interactive map, to which clinical trials were later added.
Following the methodology, a global review of peer-reviewed and grey literature was undertaken to collate information for each study/programme identified. Where possible, draft entries were sent to the study or programme lead to ensure that the data collected were accurate and up to date.
The contents of the map will be updated on a regular basis and iteratively expanded to capture both earlier research and new initiatives in future editions.
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 in 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 and the preliminary roll-out of an organised programme at designated sites or geographical regions (pilots). Although the terms may be used interchangeably and the definitions can vary, these studies tend to share common research objectives around the implementation of lung cancer screening.
National or regional programmes
A formally endorsed and organised national or regional LDCT lung cancer screening programme.
Eligibility criteria for the map
Maintaining clear inclusion criteria is essential for ensuring that the scope of the interactive map continues to support its original objective – a focus on organised LDCT screening.
- Implementation studies, regional/national programmes or clinical trials (referred to as ‘study/programme’).
- The study/programme is investigating the implementation of LDCT screening for the early detection of lung cancer in high-risk individuals.
- The study/programme targets asymptomatic individuals considered to be at high risk of developing lung cancer, taking into account potential local variation in risk factors and screening protocols.
- The study/programme is focused on organised LDCT screening.
- The study/programme is not related to the implementation of LDCT screening e.g.:
- cost-effectiveness analyses outside of the context of implementation (i.e. planning or evaluating an implementation study or programme that meets the inclusion criteria)
- a study that focuses on smoking cessation outside of LDCT screening or that considers factors around the implementation of screening as secondary objectives only.
- The study/programme investigates other approaches to lung cancer screening but not LDCT (e.g. chest X-ray, conventional CT).
- The study/programme is focused on opportunistic LDCT lung cancer screening.
Process for populating the interactive map
In the first edition of the interactive map, launched in September 2022, we systematically included all ongoing or recently completed studies/programmes identified outside of the US (ending after 31 December 2014).
The second edition, launched in June 2023, required a more pragmatic approach to mapping US entries. This was due to the high number of studies/programmes that meet the inclusion criteria and the need to keep the interactive map user-friendly. As such, the process of populating the US data set is not intended to be comprehensive; the entries will continue to increase in subsequent editions of the interactive map.