Feasibility of Lung Cancer Computed Tomography Screening in Jordan: Resource Assessment and Health Impact Modeling

Lung cancer is the leading cause of cancer mortality in Jordan, with most cases presenting at advanced stages. Low-dose computed tomography (LDCT) screening has demonstrated mortality reduction in high-risk populations in developed countries. This study evaluates the feasibility and potential impact of implementing LDCT lung cancer screening in Jordan and includes a health benefit analysis.

We analyzed Jordan's at-risk population using NELSON trial eligibility criteria and 2019 STEPS smoking survey data. Current radiological resources were assessed through official government sources and compared with international benchmarks from countries with established lung cancer screening programs. Health benefits were modeled using stage migration data from the NELSON trial applied to Jordan's lung cancer registry data (2013-2022) to calculate a benefit analysis.

An estimated 622,499 Jordanians, age 50-74 years, meet screening eligibility criteria. Jordan has 37.69 radiologists per million population (PMP; range, 6.03-62.47 across governorates), compared with the modeled minimum of 65.63. CT scanner availability is 16.37 PMP, very close to the minimum requirement of 16.76 but with significant geographic disparities. Modeling suggests screening could increase stage I diagnoses from 8.38% to 35.28% and reduce stage IV diagnoses from 73% to 54%, projecting a reduction of 34.93 advanced-stage presentations annually.

Although Jordan approaches adequacy in CT scanner availability, significant radiologist shortages and geographic disparities present major implementation challenges for LDCT lung cancer screening. Modeling uncertainties and infrastructure gaps necessitates pilot studies to validate assumptions before national implementation. Targeted infrastructure investment and workforce development are essential prerequisites for effective lung cancer screening in Jordan.