Lung Cancer Clinical Trial
Official title:
Korean Lung Cancer Screening Project for High-risk Smokers to Evaluate Effectiveness and Feasibility of Lung Cancer Screening With Low-dose Computed Tomography for Implementing National Cancer Screening Program
Lung cancer is by far the leading cause of cancer death and has a lower relative survival
rate than other types of cancer because most lung cancers are detected at an advanced stage
when they are first diagnosed.
Recently, a randomized control trial suggests that low-dose computed tomography (LDCT)
enables an early stage detection and it has been increasingly accepted as an efficient
screening method for high-risk individuals to reduce lung cancer mortality.
In 2011, The National Lung Screening Trial (NLST) in the U.S. has produced results that
screening high-risk smoking groups (who have at least 30 pack-year smoking history and
currently smoke or have quit within the past 15 years) aged 55 to 74 years with LDCT reduced
lung cancer mortality by 20%.
Based on the evidence, Korean National Cancer Center has developed and published the
guideline of lung cancer screening using LDCT for high-risk populations in 2015. The
guideline recommends annual LDCT screening for high-risk smoking groups aged 55 to 74 years,
with at least 30 pack-year smoking history and current smokers or past smokers who quit
smoking within 15 years.
The Korean Lung Cancer Screening project (K-LUCAS), a nationwide, multicenter, prospective
study started to evaluate the effectiveness and feasibility of lung cancer screening with
LDCT for considering implementation of a national lung cancer screening program in Korea.
◎ Objective
This study is to evaluate the effectiveness and feasibility of lung cancer screening with
LDCT for considering implementation of a national Lung Cancer Screening Program in Korea.
◎ Recruiting procedure
K-LUCAS involves 14 general hospitals located nationwide. The participants in K-LUCAS are
recruited from the visitors in these hospitals for receiving national cancer screenings or
smoking cessation services. The candidates are evaluated based on the questionnaire that is
completed in prior to the national cancer screenings or smoking cessation services.
Invitations will be sent to those candidates who meet our selection criteria to take part in
LDCT lung cancer screening. Advertising to public including the information both of screening
benefit and harm will be held in hospitals, newspaper, local bus stations and subways.
In addition to the criteria-based participant selection, a lung cancer risk prediction model
will be adopted to improve the effectiveness of participant selection. The lung cancer risk
prediction model considers various lung cancer risk factors in addition to age, smoking
history and smoking quit duration which are already examined in the inclusion criteria. The
model evaluates drinking amount, physical activity, family history of cancer, past history of
lung disease and so on, in participant selection.
◎ Screening procedure
If the candidate meets the selection criteria or is approved by risk prediction model,
investigators carefully explain the benefits or harms of the LDCT screening and offer them to
participate in a LDCT lung cancer screening. If the candidate agrees on screening
participation, an informed consent form is obtained and LDCT screening date is scheduled and
confirmed. K-LUCAS also provides a smoking cessation counselling to current smokers on
revisiting for the result counselling. A follow-up call is made after 6 months from the LDCT
screening in order to assess smoking cessation status following LDCT screening.
◎Reporting LDCT results
The LDCT screening results are evaluated by radiologists in accordance with Lung imaging
reporting and data system (Lung-RADS).
Network-based computer-aided detection (CAD) system will be used in K-LUCAS to assist
reducing diagnostic errors and increasing lung nodule detection sensitivity.
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