Lessons Learned From International Lung Cancer Screening Trials; People at Risk Deserve Screening for Early Detection

In the modern era, the role of lung cancer screening by low dose computed tomography (CT) is now broadly accepted, with many jurisdictions offering or intending to offer population-based screening based on high quality randomised controlled trial (RCT) evidence. Optimal implementation will be crucial to ensure sufficiently high participation rates in efficient quality assured lung cancer screening programmes (LCSPs) to achieve the gains predicted by modelling and health technology assessments. Performed well, LCSPs can be anticipated to complement the reduction in lung cancer burden already realised from the introduction of molecularly targeted agents and immune checkpoint inhibitors for advanced stage lung cancer. In this review, we will describe the recent clinical developments from published trials to highlight contemporaneous lung cancer screening (LCS) issues and discuss potential enablers and barriers to the effective implementation of LCSP commonly encountered across the world, particularly from the viewpoint of the Asia Pacific region and peoples.