Mobile low-dose computed tomography (LDCT) screening may be able to reach high-risk and socially vulnerable populations in resource-limited settings, according to initial results from the Third Brazilian Early Lung Cancer Trial (BRELT3) presented at the International Association for the Study of Lung Cancer (IASLC) 2026 World Conference on Lung Cancer (WCLC) (Abstract MO14.03).
BRELT3 Seeks to Expand Screening
In earlier trials (BRELT1 and BRELT2), the feasibility of LDCT screening in geographically underserved populations was demonstrated. BRELT3 sought to expand screening through a mobile CT unit employed across four cities in Northeast Brazil from 2023 to 2025. The prospective, single-arm observational study focused on individuals aged 50 to 80 years who were current or former smokers. Media campaigns and active outreach by trained community health workers were employed to recruit participants.
Among 5,223 people identified as potential participants, 2,018 met eligibility criteria and underwent LDCT screening. The mean age was 62 ± 7 years, 53% were women, 87% self-identified as non-White, and 64% had primary-level education. Current smokers accounted for 58.8% of participants with a median tobacco exposure of 40 pack-years. Further, 70.7% of participants had high or very high nicotine dependence.
LDCT findings classified as Lung-RADS 3 or 4 were observed in 283 participants. Biopsy was indicated for 46 participants, with 34 procedures performed and 19 lung cancers diagnosed, representing 0.94% of those screened. Seven patients were diagnosed at advanced stages and seven underwent surgical treatment.
Community Health Workers Key to Recruitment
Community health workers contributed to the recruitment of 894 participants, or 44.3% of the screened population. People recruited through community health workers were more likely to have lower educational levels, live in rural areas, and be current smokers. Among rural participants, nearly 60% were recruited through community health workers.
The researchers concluded that mobile LDCT lung cancer screening is feasible among socially vulnerable populations in resource-limited settings and that community-based recruitment can improve inclusion of high-risk and underserved groups. The findings support expansion of organized screening programs aimed at improving equitable access and reducing lung cancer mortality.
“These initial findings demonstrate that mobile low-dose CT screening can be successfully implemented in resource-limited settings and can reach people who may otherwise face substantial barriers to lung cancer screening,” said presenting author Ricardo Sales dos Santos, MD, PhD, of ProPulmão Institute in Salvador, Brazil. “Community health workers were particularly important in connecting rural and socially vulnerable individuals with screening.”
DISCLOSURE: For full disclosures of the study authors, visit abstractsonline.com.
