New Delhi: A global policy report on lung cancer screening has called for health systems to move beyond the question of whether low-dose computed tomography (LDCT) screening works, and focus on how it can be implemented effectively, equitably and sustainably – lessons that could be particularly relevant for India.
The report, ‘Advancing Lung Cancer Screening: Learning from Implementation in Europe’, released by the Lung Cancer Policy Network, identifies four key priorities for a successful screening programme – identifying people at highest risk, targeted outreach to improve participation, integrating screening with wider public health initiatives and embedding screening within existing health systems.
Experts say the recommendations assume significance for India, where lung cancer remains a major cause of cancer-related mortality and patients are often diagnosed at an advanced stage.
The report cautions against a one-size-fits-all approach and emphasises that eligibility criteria for screening should reflect local population risk profiles and evolve through evidence generation and validation of risk-based approaches, said Dr Abhishek Shankar, assistant professor at the Department of Radiation Oncology at AIIMS,Delhi.
“This is particularly relevant for India, where tobacco use is an important risk factor but lung cancer risk is also influenced by ambient and household air pollution, occupational exposure to carcinogens, second-hand smoke and other environmental factors,” Dr Shankar, who has contributed to the report from India, said.
The report is also significant in the context of the growing engagement of Dr Shankar in global lung cancer policy and implementation research.
Through participation in international initiatives, including the WHO/IARC Lung Cancer Screening Handbook process and the Lung Cancer Policy Network, Dr Shankar has contributed an Indian and LMIC perspective to global discussions on lung cancer screening and early detection.
At AIIMS Delhi, these priorities are being translated into locally relevant research through initiatives including the Indian Lung Screening Trial and AIRCARE, which focus on generating evidence for risk-based screening and understanding the role of environmental exposures and air pollution in lung cancer risk, he said.
This work is particularly important for developing screening strategies relevant to India’s unique population and environmental context.
The report also stresses that screening should not operate in isolation but be integrated with smoking cessation services, primary care, digital health systems, diagnostic pathways and adequate capacity for timely treatment.
For India, Dr Shankar said, the global experience provides an opportunity to develop screening strategies based on the country’s own risk patterns and health-system realities rather than directly adopting criteria developed in Europe or North America.
The report also underlines the growing role of countries such as India in shaping the global evidence base on lung cancer screening, particularly for low- and middle-income settings, where health systems face different disease burdens and resource constraints, he said.
