Lung cancer screening with three annual low dose computed tomography (CT) scans of the chest has been shown to detect lung cancer early. Detecting lung cancer early significantly improves survival rates for lung cancer. Two large studies in the US and Europe demonstrated that screening high risk smokers with yearly low dose CT decreased lung cancer mortality by 20% and overall mortality by 7% among more than 50,000 patients screened. It has been demonstrated to be cost effective in Canada and has been recommended by the Canadian Task Force on Preventative Health Care in April 2016. This represents the most important change in lung cancer management in more than 10 years. My research program aims to tailor health care interventions to optimize lung cancer screening practices in Québec.
Firstly, I will establish a nurse run lung cancer screening program. We will calculate lung cancer risk in each patient who registers for screening in order to offer screening only to those smokers who are at elevated risk for lung cancer. We will determine methods to avoid screening patients who are at high risk of receiving harms from screening (such as risks of complications from of invasive procedures and limiting overdiagnosis of lung cancer which would not impact survival). We will also determine the best method to offer smoking cessation to patients interested in screening, as this will also improve overall survival of participants interested in screening. Secondly, my program will incorporate artificial intelligence technologies to improve guideline concordance in radiologist recommendations, and detection of lung cancer on CT scans of the chest performed to detect lung cancer early.