Researchers have found that the Taiwan National Lung Cancer Early Detection Program successfully detected 85% of stage 0 and stage I lung cancer cases. The findings by Yang et al were presented at the International Association for the Study of Lung Cancer (IASLC) 2023 World Conference on Lung Cancer.
Background
Lung cancer is the leading cause of cancer-related mortality globally and in Taiwan. To combat lung cancer and improve survival rates, Taiwan introduced the Taiwan National Lung Cancer Early Detection Program. The new program aimed to detect lung cancer early through low-dose computed tomography (CT) lung cancer screening, targeting individuals with a family history of lung cancer and a history of heavy smoking.
Timely detection may be crucial to improving lung cancer outcomes, and low-dose CT lung cancer screening has been proven effective in reducing mortality rates—particularly among those who have a history of heavy smoking. However, the existing screening criteria in the United States and South Korea limit eligibility to heavy smokers only, leaving a substantial portion of the population at risk.
Study Methods and Results
The TALENT trial provided critical insights that having a family history of lung cancer may be a significant risk factor for developing lung cancer in Taiwan. Building on this knowledge, Taiwan launched its national lung cancer screening program in July 2022 in order to target two eligible populations:
- Individuals with a family history of lung cancer—specifically those who are male aged 50 to 74 years and female aged 45 to 74 years, whose parents, children, or siblings have been diagnosed with lung cancer
- Individuals aged 50 to 74 years with a history of heavy smoking—30 or more pack-years—who are willing to quit smoking or have quit within the past 15 years.
The new program utilized a modified Lung CT Screening Reporting and Data System from the American College of Radiology as the nodule management guideline and established a case management system to ensure appropriate follow-up for positive screening results. The collected data included risk factors, image interpretation results, and evaluation outcomes, which were used to facilitate timely diagnosis and treatment.
The researchers reported that the preliminary results from July 2022 to June 2023 have been promising. A total of 49,508 individuals were screened, 58% (n = 28,617) of whom had a family history of lung cancer and 38% (n = 18,970) of whom were heavy smokers. Among those who participated in screening, 4,406 individuals received a positive screening result, and 531 individuals were ultimately diagnosed with lung cancer. The positive rate was 9.2%, and the lung cancer detection rate was 1.1%. However, 85% of the lung cancer cases were diagnosed at an early stage (stage 0 or stage I).
“The Taiwan National Lung Cancer Early Detection Program is a significant step forward in the fight against lung cancer, offering hope for saving lives through early detection and improved treatment outcomes,” concluded co–study author Pan-Chyr Yang, MD, PhD, of the National Taiwan University Hospital.
