BASIC DATA OF THE RESEARCH PROJECT

• ARRS code: V3-2321
• TITLE: Framework development for evidence-based, sustainable implementation of organised population-based lung cancer screening in Slovenia (LUKA)
• PRICE CLASS: C
• PROJECT LEADER: assist. prof. Martina Vrankar, PhD
• APPLICANT RESEARCH ORGANISATION: Institute of Oncology Ljubljana
• PARTICIPATING ORGANISATION:
  • University Clinic Golnik
  • University Medical Center Ljubljana
  • University Medical Center Maribor
  • Faculty of Mathematics and Physics

• DURATION: 1.10.2023 – 30.9.2025

• FINANCING: Ministry of Health and Slovenian Research and Innovation Agency

SHORT SUMMARY

Lung cancer represents an important public health problem. Despite the new methods of treatment, the mortality rate in Slovenia remains the highest among all cancers. Five-year survival rate in patients with lung cancer remains low, only around 20%. Latest research data has shown that lung cancer screening can significantly reduce lung cancer mortality in smokers due to the detection of lung cancer in its early stages. Based on the results of the studies, a new Recommendation of the Council of the European Union (EU) was published in December 2022. The Recommendation called on member states to study the feasibility and effectiveness of using computed tomography with low radiation doses for screening in persons at high risk of lung cancer. It also recommends to link screening examinations with primary and secondary prevention approaches to reduce the prevalence of smoking. The screening program for lung cancer is significantly different from already established screening programs. Smoking is the risk factor in the development of lung cancer in 80 – 90%. The target population in the screening are smokers and not the entire population of a certain age. The Council of the EU recommends implementation pilot research prior to population-based organized screening, which will enable determining the appropriateness of the program in a specific population.

In accordance with the goals of the project, the specific objectives of the project are:

• To prepare a systematic review of the scientific evidence regarding the justification of new screening from the perspective of the consolidated Wilson-Jungner criteria, including the identification of key challenges and expected health benefits and harms when introducing organized population screening.

• To prepare an analysis of the situation in Slovenia in the field of clinical and public health services and measures for controlling lung cancer, including primary and secondary prevention measures.

• To prepare a draft of the Program Guidelines for the new screening program, in accordance with the instructions in the Rules on the Implementation of State Screening Programs for the Early Detection of Precancerous Changes and Cancer (Official Gazette of the Republic of Slovenia, No. 57/18 and 68/19), including an integration plan screening with primary prevention of lung cancer.

• To prepare a draft of professional guidelines for the new screening program and the individual's clinical path through the screening program from invitation, screening, triage, additional diagnostics, treatment and follow-up after treatment.

• To prepare a cost-effectiveness analysis of the selected screening strategies, which will include both management and health services and which will show the need for resources (personnel, equipment, infrastructure, finances...) as well as health benefit, health harm and the costs of the new program compared to the existing situation in the country.

• To prepare an implementation research protocol and action plan for evidence-based and sustainable implementation of organized population screening, which may include several different approaches that will be tested in practice.