Risk-based lung cancer screening with low-dose computed tomography in a Canadian province: Evaluation results of a demonstration project in Quebec, Canada
Menée au Québec auprès de 3 200 fumeurs ou anciens fumeurs à haut risque de développer un cancer du poumon, cette étude évalue la performance globale d'un programme de dépistage par tomographie à faible dose de rayonnements (indicateurs évalués : taux de détection, taux de cancers détectés à un stade précoce, taux de faux positifs et taux de participation aux différentes sessions)
Background : A Lung Cancer Screening Demonstration Project using low-dose computed tomography (LDCT) was launched in Quebec, Canada to inform province-wide lung cancer screening implementation. This study analyses key performance indicators of the screening pathway.
Methods : High-risk smokers and ex-smokers were referred or self-referred for screening. Eligibility was based on the Prostate, Lung, Colorectal and Ovarian (PLCOm2012noRace) 6-year risk (
≥
2%). Lung-RADS 3 and Lung-RADS 4 rates, lung cancer detection and false-positive rates, and early-stage cancer proportion (TNM stages I and II), along with other performance indicators, were computed for the two first screening rounds.
Results : Between June 2021 and November 2022, 8416 individuals were referred to the project, and 4422 were eligible (53.4%; target
≥
50%). The first 3200 participants were included in the study. Mean PLCOm2012noRace risk was 5.2%. In round 1, Lung-RADS 4 occurred in 6.8% of participants (target
≤
10%), with a cancer detection rate of 1.7% (target
≥
1.5%), and a false-positive rate of 5.3% (target
≤
10%). In round 2, Lung-RADS 4 rate was 4.0% (target
≤
5%), with a cancer detection rate of 0.8% (target
≥
0.7%), and a false-positive rate of 3.2% (target
≤
5%). Early stage cancers accounted for 85.2% in round 1 and 84.2% in round 2 (target
≥
70%). Adherence to the next screening among Lung-RADS 1 or 2 participants was
≥
81% across both rounds (target
≥
70%). Overall, 91.1% of screen-detected cancers received curative treatment (target
≥
65%).
Conclusion : Results showed good performance strengthening evidence on key indicators pertaining to benefits and harms of lung cancer screening within a provincial public health care system.
Journal of Medical Screening , résumé, 2026