Lung Cancer Screening Program Quality Indicators-Review and Recommendations: An International Association for the...

Area of Science:

• Pulmonology
• Radiology
• Public Health
• Oncology

Background:

• Low-dose computed tomography (LDCT) for lung cancer screening (LCS) reduces mortality in high-risk populations.
• Evaluating and monitoring LCS programs is crucial for quality, efficiency, and patient outcomes.
• A lack of consensus on quality indicators (QIs) hinders effective LCS program evaluation.

Purpose of the Study:

• To develop a consensus set of quality indicators (QIs) for lung cancer screening (LCS) programs.
• To establish standardized metrics for evaluating LCS quality, efficiency, and participant outcomes.
• To provide a framework for the development and improvement of LCS initiatives.

Main Methods:

• A Delphi process involving twenty multidisciplinary experts from the International Association for the Study of Lung Cancer.
• Consideration of 50 potential QIs through information/discussion sessions and two anonymous voting rounds.
• Consensus defined as 80% or more agreement (agree or strongly agree) on a five-point Likert scale.

Main Results:

• Twenty essential and six desirable QIs were identified across 10 of 11 LCS pathway domains.
• Key domains include screening entry, smoking cessation, imaging, adherence, diagnosis, outcomes, harms, treatment, wait times, and equity.
• Specific QIs address screening eligibility, intervention offers, diagnostic assessments, adherence rates, detection rates, stage distribution, complications, treatment intent, wait times, and health equity.

Conclusions:

• A consensus set of recommended LCS QIs has been established by expert review.
• These QIs provide a foundation for developing and enhancing lung cancer screening programs.
• Implementation of these QIs is advised to ensure and improve the quality of LCS initiatives.