Abstract 154P
Background
Strong evidence of lung cancer screening's effectiveness in mortality reduction, for example as demonstrated in the National Lung Screening Trial (NLST) in the US and the Dutch-Belgian Randomized Lung Cancer Screening Trial (NELSON) has prompted countries to implement formal lung cancer screening programs. However, participation level remains largely low. This study aims to understand how lung cancer screening programs are currently performing. It also identifies the barriers and enablers contributing to adoption of lung cancer screening across seven case study countries which may be relevant for the recently adopted Council Recommendations on Cancer Screening in the EU.
Methods
A literature review about lung cancer screening programs in Canada, China, Croatia, Japan, Poland, South Korea and the United States was conducted covering academic articles, governmental official reports, non-governmental organization (NGO) reports and media reports. Findings were distilled into key themes which impact adoption. The research was validated with local experts, representing payer, policy advisor, patient, and the private sector perspectives.
Results
Adoption rates of formal lung cancer screening programs (the percentage of the target population screened) vary significantly from 4% to 53% across studied countries. The analysis finds five main factors impacting adoption: (1) political prioritization of lung cancer (2) financial incentives/cost sharing and hidden ancillary costs (3) infrastructure to support provision of screening services (4) awareness around lung cancer screening and risk factors and (5) cultural views and stigma around lung cancer. Although common across most countries, the weighting of each factor on driving or hindering adoption varies by country.
Conclusions
The variation in adoption of lung cancer screening requires heightened focus. The five areas set out by this research need to be factored into policy making to maximize effectiveness of lung cancer screening programs, such as country implementation of the Council Recommendation on Cancer Screening in Europe.
Legal entity responsible for the study
Merck & Co., Inc.
Funding
Merck & Co. Inc.
Disclosure
All authors have declared no conflicts of interest.