Quality assurance in lung cancer screening

Area of Science:

• Medical Imaging
• Public Health
• Oncology

Background:

• Screening program effectiveness hinges on accurate tests, especially those relying on clinical expertise.
• Auditing reader performance in image-based cancer screening is challenging due to data accumulation delays.
• Delayed identification of underperformance can necessitate participant recalls and erode program confidence.

Purpose of the Study:

• To develop the first External Quality Assurance (EQA) process for lung cancer screening.
• To adapt and apply lessons learned from over 30 years of breast cancer screening EQA.
• To establish a rapid method for assessing and assuring clinical expertise in lung cancer screening.

Main Methods:

• Utilizing test datasets with confirmed clinical outcomes for rapid expertise assessment.
• Leveraging established methodologies from the UK's long-standing breast cancer screening EQA program.
• Describing the developmental process of a novel EQA for lung cancer screening.

Main Results:

• Established the foundational framework for the first lung cancer screening EQA process.
• Demonstrated the feasibility of rapidly assessing reader expertise using EQA methodologies.
• Identified areas for future development and refinement of the lung cancer screening EQA.

Conclusions:

• External Quality Assurance (EQA) provides a vital mechanism for ensuring reader expertise in cancer screening.
• The developed EQA process for lung cancer screening is adaptable and builds upon successful breast cancer screening models.
• Ongoing development of EQA is crucial for maintaining high standards and public confidence in screening programs.