Korean Lung Cancer Screening Project

Lung cancer is by far the leading cause of cancer death and has a lower relative survival rate than other types of cancer because most lung cancers are detected at an advanced stage when they are first diagnosed. Recently, a randomized control trial suggests that low-dose computed tomography (LDCT) enables an early stage detection and it has been increasingly accepted as an efficient screening method for high-risk individuals to reduce lung cancer mortality. In 2011, The National Lung Screening Trial (NLST) in the U.S. has produced results that screening high-risk smoking groups (who have at least 30 pack-year smoking history and currently smoke or have quit within the past 15 years) aged 55 to 74 years with LDCT reduced lung cancer mortality by 20%. Based on the evidence, Korean National Cancer Center has developed and published the guideline of lung cancer screening using LDCT for high-risk populations in 2015. The guideline recommends annual LDCT screening for high-risk smoking groups aged 55 to 74 years, with at least 30 pack-year smoking history and current smokers or past smokers who quit smoking within 15 years. The Korean Lung Cancer Screening project (K-LUCAS), a nationwide, multicenter, prospective study started to evaluate the effectiveness and feasibility of lung cancer screening with LDCT for considering implementation of a national lung cancer screening program in Korea.

Sex

All

Minimum age

55 Years

Maximum age

74 Years

We select participants based on the following criteria.

* Inclusion Criteria (1)

  * Age : 55-74 years old
  * Smoking history of at least 30 pack-years

    1. current smokers
    2. past smokers who quit smoking within 15 years
* Inclusion Criteria (2) The lung cancer risk prediction model considers various lung risk factors in addition to age, smoking history and smoking quit duration. This includes drinking amount, physical activity, family history of cancer, information on lung disease and so on, in participant selection. Following criteria is applied when the lung cancer risk prediction model is used for participant selection.

  * Age : 50-74 years old
  * Smoking history of at least 20 pack-years

    1. current smokers
    2. past smokers who quit smoking within 15 years
* Exclusion Criteria:

  * Lung cancer diagnosed and treated
  * Inability to move without help (ECOG status 2 or higher)
  * Have been treating regularly for tuberculosis, pneumonia and interstitial lung disease
  * Treated for any cancer within the last 5 years (\*Exception: Thyroid cancer, Skin cancer)
  * A chest CT examination less than 6 months

• BACKGROUNDNational Lung Screening Trial Research Team; Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, Gareen IF, Gatsonis C, Marcus PM, Sicks JD. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011 Aug 4;365(5):395-409. doi: 10.1056/NEJMoa1102873. Epub 2011 Jun 29. PMID 21714641
• BACKGROUNDFintelmann FJ, Bernheim A, Digumarthy SR, Lennes IT, Kalra MK, Gilman MD, Sharma A, Flores EJ, Muse VV, Shepard JA. The 10 Pillars of Lung Cancer Screening: Rationale and Logistics of a Lung Cancer Screening Program. Radiographics. 2015 Nov-Dec;35(7):1893-908. doi: 10.1148/rg.2015150079. Epub 2015 Oct 23. PMID 26495797
• BACKGROUNDPedersen JH, Sorensen JB, Saghir Z, Flotten O, Brustugun OT, Ashraf H, Strand TE, Friesland S, Koyi H, Ek L, Nyren S, Bergman P, Jekunen A, Nieminen EM, Gudbjartsson T. Implementation of lung cancer CT screening in the Nordic countries. Acta Oncol. 2017 Oct;56(10):1249-1257. doi: 10.1080/0284186X.2017.1329592. Epub 2017 Jun 1. PMID 28571524
• BACKGROUNDYousaf-Khan U, van der Aalst C, de Jong PA, Heuvelmans M, Scholten E, Walter J, Nackaerts K, Groen H, Vliegenthart R, Ten Haaf K, Oudkerk M, de Koning H. Risk stratification based on screening history: the NELSON lung cancer screening study. Thorax. 2017 Sep;72(9):819-824. doi: 10.1136/thoraxjnl-2016-209892. Epub 2017 Mar 30. PMID 28360223
• BACKGROUNDPaci E, Puliti D, Lopes Pegna A, Carrozzi L, Picozzi G, Falaschi F, Pistelli F, Aquilini F, Ocello C, Zappa M, Carozzi FM, Mascalchi M; the ITALUNG Working Group. Mortality, survival and incidence rates in the ITALUNG randomised lung cancer screening trial. Thorax. 2017 Sep;72(9):825-831. doi: 10.1136/thoraxjnl-2016-209825. Epub 2017 Apr 4. PMID 28377492
• BACKGROUNDHan SS, Ten Haaf K, Hazelton WD, Munshi VN, Jeon J, Erdogan SA, Johanson C, McMahon PM, Meza R, Kong CY, Feuer EJ, de Koning HJ, Plevritis SK. The impact of overdiagnosis on the selection of efficient lung cancer screening strategies. Int J Cancer. 2017 Jun 1;140(11):2436-2443. doi: 10.1002/ijc.30602.