Integrated lung Cancer Screening program employing a mobile unit in Brazil

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Introduction: Lung cancer screening (LCS) has been shown to reduce lung cancer deaths in high-risk subjects of high-income countries. Implementation of LCS programs can be a challenge when resources are limited. Barretos Cancer Hospital implemented a LCS program using a mobile unit with a low-dose computed tomography(LDCT). This strategy has improved the recruitment of high-risk subjects. Aims: To describe results from an integrated LCS program using a mobile unit in Brazil. Methods: From May 2019 to January 2023, high-risk subjects according to NLST and/or PLCOm2012 criteria were invited to perform LCS in a mobile LDCT unit and were offered tobacco cessation counselling. LDCT results were classified according to LungRADS and discussed in multidisciplinary meetings. Suspicious lesions were investigated by minimally invasive biopsy. Results: We included 312 subjects, of which 201 were eligible according to either NSLT and PLCO criteria, 63 according to only NLST criteria, and 48 according to only PLCO. Most subjects were women(n=170;54%), with mean age of 64 years old. Half of participants showed high/very-high nicotine dependence. In the first LDCT, most participants (n=230;74%) exhibited LungRADS1/2, 4.5% LungRADS3(n=14), 5.8% exhibited LungRADS4a(n=18); and 0.6% LungRADS4b/4x(n=2). Five screened subjects underwent excisional biopsy(1.6%) and 4 of them presented lung cancer (1.3%), leading to a lung cancer rate of 12.8/1000. Among lung cancers, two were classified as adenocarcinoma and two as squamous cell carcinoma. One case was diagnosed at stage IA2, 1 as stage IB, and 2 as stage IIB. Conclusion: The integrated LCS program using a mobile unit in Brazil has proven to be a successful strategy in identifying high-risk subjects and detecting early-stage lung cancer.

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