Screening for Lung Cancer in India: Expert Opinion Statement.

Area of Science:

• Oncology
• Public Health
• Radiology

Background:

• Lung cancer (LC) poses the highest disability-adjusted life years (DALY) burden among cancers in India.
• Most Indian LC patients present with advanced disease, leading to poor survival outcomes.
• Early diagnosis is crucial for curative treatment and improved survival.

Purpose of the Study:

• To review the feasibility and propose a framework for a risk-based lung cancer screening (LCS) program in India.
• To identify specific risk factors and characteristics of the Indian population at risk for LC.
• To discuss challenges and facilitators for implementing LCS in India.

Main Methods:

• Expert panel review synthesizing literature on LC burden, diagnosis, barriers, and risk factors in India.
• Analysis of international LCS guidelines and data on Indian LC epidemiology.
• Assessment of risk factors including age, smoking (bidi), biomass smoke exposure, and air pollution.

Main Results:

• India lacks a formal LCS program despite high LC burden.
• Key risk factors in India include younger age, bidi smoking, biomass fuel smoke, and air pollution.
• Indian LC cases show a higher prevalence of driver mutations and adenocarcinoma histology.

Conclusions:

• A risk-based lung cancer screening program using low-dose computed tomography (LDCT) is recommended for India.
• Addressing specific Indian risk profiles and implementing a multidisciplinary team (MDT) approach are crucial.
• Further research and strategic planning are needed for effective LCS implementation in India.