1568P - Challenges in pilot lung cancer screening in Vojvodina, Serbia

Background

Lung cancer (LC) screening is an effective secondary preventive measure in decreasing LC mortality. Except for age and smoking history prediction models with additional variables were verified in different populations. In September 2020 the first pilot program for early detection of LC started in Vojvodina, Serbia. To increase LC positive findings we analyze characteristics of screening participants from September 2020 to April 2024.

Methods

Eligibility for LC screening is restricted to persons aged 50-74 years, with a smoking history of 30 pack-years, or 20 pack-years with additional risks; either active or quit smoking within the previous 10 years. Participants sign informed consent and fill out an online questionnaire with socio-demographic data (age, gender, marital, education, working status), smoking status (pack-years), exposure data (professional, tobacco exposure in childhood, in adulthood), BMI, alcohol consumption, symptoms of respiratory diseases, presence of chronic disease or cancer of other localization, and family history of LC. Screening results were reported by Lung RADS score (1 to 4). Differences between participants with positive (score 4) and negative or intermediate (score 1 to 3) results were analyzed.

Results

During the observed period, 61.3% (1690/2759) of screened were females. Positive screens were reported in 264(9.6%) of participants. Characteristics of participants divided by scores (4 vs score 1-3) showed differences in age (64.03±6.62 vs 61.54±6.71, p<0.001), BMI (25.35±3.87 vs 26.64±4.58, p<0.001), years of smoking (38.82±9.47 vs 37.01±8.60, p=0.001), pack-years (42.59±17.06 vs 39.49±16.20, p=0.003), appetite loss (11.4% vs 6.7%, p=0.005), and weight loss (14.4% vs 8.1%, p<0.001). Significant differences were observed between participants according to employment (p<0.001) and education level (p=0.022); retired (60.6% vs 44.3%) and finished primary school (14.0% vs 8.6%) were more common in score 4, while employed (43.2% vs 27.3%) and faculty education (23.7% vs 19.7%) in score 1-3.

Conclusions

Reaching more elderly and heavy smoker participants with lower BMI and lower education could increase the percentage of LC positive screening results.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Institute for Pulmonary Diseases of Vojvodina.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.