00:00Doctor Preda, where are we at with lung cancer screening and how can a screening protocol be implemented?
00:05Can early diagnosis truly become integrated into regional pathways?
00:10Lung cancer screening with low-dose lung CT is now a consolidated reality on a scientific basis
00:23demonstrated first by protocols, first by American and then European studies.
00:31The NLST study from North America and Nelson from the Netherlands have shown that screening using this diagnostic tool
00:41It is able to reduce lung cancer-specific mortality by approximately 20% by enabling the diagnosis of
00:50neoplasms in the preclinical stage and therefore curable with less invasiveness for patients.
00:58All this was later confirmed by several Italian studies.
01:03One of the challenges from an organizational point of view is also represented by the management of the many so-called incidental or
01:13collaterals that are highlighted in screening CT scans,
01:18that is, findings that do not strictly concern the search for the suspected lung cancer nodule but rather coexisting pathological conditions such as for example
01:31the possibility of coronary heart disease
01:35which is highlighted by CT of the lung through the presence of calcifications of the coronary arteries which can be quantified and
01:43If the condition is deemed significant, the patient is also referred for a cardiological evaluation.
01:53if it is not already in place in the individual patient.
01:56Then many findings even outside the lung must be properly managed to avoid what is possible
02:08negative effect,
02:09negative in quotation marks which is perhaps that of directing subjects towards checks, useless investigations which sometimes only create stress,
02:20anxiety and further economic burden on the system,
02:25therefore also in this case adequate training by specialists in the management of these findings in the subjects
02:32heavy smokers are sometimes not so uncommon either
02:37it is certainly of considerable importance.
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