2026 IASLC CT Screening and Early Detection Symposium-WS02.08 - Talk 4: Considerations in the Trade-offs Between Benefits, Harms and Resource Requirements of Expanding Lung Cancer Screening to Low-risk Populations

WS02.08 - Talk 4: Considerations in the Trade-offs Between Benefits, Harms and Resource Requirements of Expanding Lung Cancer Screening to Low-risk Populations

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The document discusses the trade-offs involved in expanding lung cancer screening beyond current high-risk eligibility criteria to include lower-risk populations.

Current screening programs mainly target people with a substantial smoking history, such as those with 20–30 pack-years or a PLCOm2012 risk of 1.51%. These criteria have been effective in trials, but they exclude many people who smoke with lighter exposure, former smokers with lower cumulative risk, and people with no smoking history.

The presentation evaluates several key questions for low-risk groups:

- <strong>Benefit:</strong> Screening is expected to still reduce lung cancer mortality, though likely less than in high-risk populations.
- <strong>Harms:</strong> A major concern is <strong>overdiagnosis</strong>, meaning detection of cancers that would not have caused symptoms or death.
- <strong>Resource requirements:</strong> Expanding screening would require more CT scans, greater healthcare capacity, and additional treatment resources.
- <strong>Cost-effectiveness:</strong> Available studies suggest extension of screening criteria may still be cost-effective.
- <strong>Capacity constraints:</strong> Practical limits in CT access and treatment availability could hinder implementation.

A major knowledge gap is the epidemiology and natural history of lung cancer in people with <strong>no smoking history</strong>. The speaker argues that more research is urgently needed in this group.

Overall, the conclusion is that lung cancer screening in lower-risk populations will likely save lives, but overdiagnosis and limited healthcare capacity are important challenges. Better ways to identify truly high-risk individuals within lower-risk groups, along with strategies to scale up screening and treatment services, are essential before broad expansion can be successfully implemented.

Asset Subtitle

Kevin ten Haaf

Meta Tag

Concept Chest Screening

Concept Overdiagnosis

Concept High-Risk Population

Concept Low-Risk Population

Concept Mortality Benefit

Speaker Kevin ten Haaf

Keywords

lung cancer screening

low-risk populations

overdiagnosis

cost-effectiveness

CT scans

smoking history

high-risk eligibility

screening expansion

healthcare capacity

natural history

Chest Screening

Overdiagnosis

High-Risk Population

Low-Risk Population

Mortality Benefit

Kevin ten Haaf