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European Radiology
Published in: European Radiology 6/2020

01-06-2020 | Lung Cancer | Chest

ESR/ERS statement paper on lung cancer screening

Authors: Hans-Ulrich Kauczor, Anne-Marie Baird, Torsten Gerriet Blum, Lorenzo Bonomo, Clementine Bostantzoglou, Otto Burghuber, Blanka Čepická, Alina Comanescu, Sébastien Couraud, Anand Devaraj, Vagn Jespersen, Sergey Morozov, Inbar Nardi Agmon, Nir Peled, Pippa Powell, Helmut Prosch, Sofia Ravara, Janette Rawlinson, Marie-Pierre Revel, Mario Silva, Annemiek Snoeckx, Bram van Ginneken, Jan P. van Meerbeeck, Constantine Vardavas, Oyunbileg von Stackelberg, Mina Gaga, on behalf of the European Society of Radiology (ESR) and the European Respiratory Society (ERS)

Published in: European Radiology | Issue 6/2020

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Abstract

In Europe, lung cancer ranks third among the most common cancers, remaining the biggest killer. Since the publication of the first European Society of Radiology and European Respiratory Society joint white paper on lung cancer screening (LCS) in 2015, many new findings have been published and discussions have increased considerably. Thus, this updated expert opinion represents a narrative, non-systematic review of the evidence from LCS trials and description of the current practice of LCS as well as aspects that have not received adequate attention until now. Reaching out to the potential participants (persons at high risk), optimal communication and shared decision-making will be key starting points. Furthermore, standards for infrastructure, pathways and quality assurance are pivotal, including promoting tobacco cessation, benefits and harms, overdiagnosis, quality, minimum radiation exposure, definition of management of positive screen results and incidental findings linked to respective actions as well as cost-effectiveness. This requires a multidisciplinary team with experts from pulmonology and radiology as well as thoracic oncologists, thoracic surgeons, pathologists, family doctors, patient representatives and others. The ESR and ERS agree that Europe’s health systems need to adapt to allow citizens to benefit from organised pathways, rather than unsupervised initiatives, to allow early diagnosis of lung cancer and reduce the mortality rate. Now is the time to set up and conduct demonstration programmes focusing, among other points, on methodology, standardisation, tobacco cessation, education on healthy lifestyle, cost-effectiveness and a central registry.
Key Points
• Pulmonologists and radiologists both have key roles in the set up of multidisciplinary LCS teams with experts from many other fields.
• Pulmonologists identify people eligible for LCS, reach out to family doctors, share the decision-making process and promote tobacco cessation.
• Radiologists ensure appropriate image quality, minimum dose and a standardised reading/reporting algorithm, together with a clear definition of a “positive screen”.
• Strict algorithms define the exact management of screen-detected nodules and incidental findings.
• For LCS to be (cost-)effective, it has to target a population defined by risk prediction models.
Appendix
Available only for authorised users
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Metadata
Title
ESR/ERS statement paper on lung cancer screening
Authors
Hans-Ulrich Kauczor
Anne-Marie Baird
Torsten Gerriet Blum
Lorenzo Bonomo
Clementine Bostantzoglou
Otto Burghuber
Blanka Čepická
Alina Comanescu
Sébastien Couraud
Anand Devaraj
Vagn Jespersen
Sergey Morozov
Inbar Nardi Agmon
Nir Peled
Pippa Powell
Helmut Prosch
Sofia Ravara
Janette Rawlinson
Marie-Pierre Revel
Mario Silva
Annemiek Snoeckx
Bram van Ginneken
Jan P. van Meerbeeck
Constantine Vardavas
Oyunbileg von Stackelberg
Mina Gaga
on behalf of the European Society of Radiology (ESR) and the European Respiratory Society (ERS)
Publication date
01-06-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-06727-7

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