Lung Cancer Screening: Survival in an Extensive Early Detection Program in Spain (I-ELCAP).

Area of Science:

• Oncology
• Radiology
• Public Health

Background:

• Lung cancer (LC) diagnosis often occurs at advanced stages, leading to poor prognosis (12% 5-year survival).
• Previous trials (NLST, NELSON) indicate mortality reduction through lung cancer screening in high-risk individuals.
• Implementation of lung cancer screening programs is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the survival outcomes of the largest lung cancer screening program in Spain.
• To assess the effectiveness of low-dose computed tomography (LDCT) in early lung cancer detection.
• To compare findings with other significant lung cancer screening initiatives.

Main Methods:

• Analysis of clinical records from the International Early Lung Cancer Detection Program (IELCAP) in Valencia, Spain (2008-2020).
• Inclusion of ever-smokers aged 40-80 years.
• Comparison of results with similar large-scale screening programs.

Main Results:

• 8278 participants underwent a mean of 6 annual LDCT screening rounds over 12 years.
• 239 lung cancers detected; 61.3% were adenocarcinoma at stage I.
• Lung cancer prevalence was 1.5%, incidence 1.4%, with a 0.17 annual detection rate.
• Achieved 90% 1-year and 80.1% 10-year survival rates with 96.84% adherence.

Conclusions:

• The largest lung cancer screening program in Spain demonstrates improved survival.
• Screening effectiveness is enhanced within a multidisciplinary team experienced in LC management.
• Outcomes are comparable to other major lung cancer screening programs globally.