906P A pilot study of a lung cancer screening program with low-dose computed tomography in high-risk individuals in Greece

Abstract

Greece is one of the European countries with the highest prevalence of smoking. Low-dose computed tomography (LDCT) has been proposed as a useful tool for the early detection of lung cancer, with the potential to reduce death rates. Given the fact that Greece has no National Lung Cancer Screening program, the pilot REGISTRY study was designed to assess the effects of baseline screening with LDCT in high-risk individuals. From January 2016 to March 2022, 1500 individuals aged > 45 years with smoking history of at least 15 pack-years, were recruited in the study. Former smokers needed to quit within 15 years from study entry to be eligible. Each participant was advised to undergo annual screening with LDCT for ten years and the evaluation was based on the updated NCCN guidelines. A high rate of adherence to screening (90.1%) was reported. The median age of participants was 63 years and the number of pack years ranged from 15 to 72 (median 30 years). In total, 697 subjects (46,4%) reported at least one comorbidity including hypertension, diabetes mellitus, COPD and/or prior cancer. The rate of positive screening tests was 0,66% (10 of 1500 patients). Eight patients were diagnosed with cancer at baseline LDCT, while the rest within two years from initiation of screening. All ten patients were diagnosed with non-small cell lung cancer (adenocarcinoma=5 and squamous cell carcinoma N=5). All patients underwent surgery. Seven patients were diagnosed with stage I, two with stage II and one with stage III disease. Real-world data from this pilot study in Greece are concordant with large randomized phase III screening trials and confirm the utility of LDCT as a potent strategy for the early detection of lung cancer. A National Lung Cancer screening program should become a priority for Greek health policy makers.