Lung Cancer Screening Pilot for People at High Risk
Lung cancer is the leading cause of cancer death for people in Ontario. The reason so many people die from lung cancer is that by the time it is usually diagnosed, the cancer has spread to other parts of the body or is too big. When the cancer has spread or is too big, treatment has less of a chance of working. Regular screening is important because it can find lung cancer early when treatment has a better chance of working.
Lung Cancer Screening Pilot for People at High Risk (the pilot)
Cancer Care Ontario recommends using low-dose computed tomography (LDCT) through an organized cancer screening program to screen people at high risk of getting lung cancer. For evidence and rationale behind this recommendation, see the Frequently Asked Questions for Healthcare Providers.
We launched the pilot in June 2017 at specific hospitals in Ontario. The main purpose of the pilot is to assess how to best implement organized lung cancer screening for people at high risk across Ontario.
Locations of Pilot Site Hospitals
The pilot is based out of the following hospitals in Ontario. Contact the hospitals directly with questions about the pilot or to submit referrals. This contact information has been provided by the pilot site hospitals.
|PILOT SITE HOSPITAL||LOCATION||AFFILIATED SITES||PHONE||FAX|
|The Ottawa Hospital||Ottawa||Renfrew Victoria Hospital
Cornwall Community Hospital
|Health Sciences North||Sudbury||n/a||705-523-7301
|Lakeridge Health||Oshawa||n/a||1-905-576-8711 ext. 34449||905-721-4864|
|University Health Network||Toronto||n/a||416-340-4154||416-340-4137|
Benefits of Organized Lung Cancer Screening
Screening people at an official pilot site hospital provides several benefits of an organized cancer screening program:
- Screening people at the recommended interval
- Appropriate and timely follow-up of abnormal findings
- Ongoing quality monitoring, reporting and performance management
The pilot, like organized cancer screening programs, also reinforces the benefits of screening and ensures greater protection against the potential risks of screening.
The pilot uses a detailed organized lung cancer screening pathway, and a comprehensive evaluation and performance management framework.
Responsibilities of Pilot Site Hospitals
- Determining eligibility for screening by conducting a risk assessment using a risk calculator
- Empowering people to make informed decisions about participating in screening
- Providing smoking cessation support
- Conducting a baseline LDCT scan and ongoing routine annual screening
- Ensuring that scans are interpreted by radiologists who have been trained to read screening LDCT scans
- Ensuring follow-up of nodules if follow-up is recommended according to Lung-RADSTM
- Ensuring that all screening LDCT scans are reported using a standardized radiology template based on the American College of Radiology’s Lung-RADSTM classification system
- Communicating screening results, incidental findings (i.e., findings other than lung nodules) and next steps to referring physicians and primary care providers (if different)
- Enabling seamless transition for lung diagnostic assessment for investigation of findings that could be cancer
- Providing participants with navigation support throughout the screening process without any judgement
- Reporting data to Cancer Care Ontario so we can develop performance and quality metrics
Risks of Screening Outside of the Pilot (Opportunistic Screening)
People screened outside of organized lung cancer screening may:
- get a diagnostic computed tomography (CT) scan, which may use intravenous contrast and exposes them to several times the amount of radiation of an LDCT scan or chest X-ray
- also have unnecessary follow-up testing, which may lead to unnecessary radiation exposure and invasive diagnostic procedures.
If a primary care provider feels that a patient needs a CT scan because their risk of developing lung cancer is high, it is important to consider whether the benefits would outweigh the potential harms of a scan. Primary care providers should use their discretion and consider a patient’s individual circumstances when making a decision about their care.
Resources for Suspected Lung Cancer
Screening is not appropriate for people with suspected lung cancer. If someone has lung cancer symptoms, follow the Program in Evidence-Based Care’s guidelines for referral of suspected lung cancer and Cancer Care Ontario’s lung cancer diagnosis pathway.
For More Information
For more information about the importance of organized lung cancer screening and general information about the pilot, please see the Frequently Asked Questions for Healthcare Providers.
For answers to other questions regarding the pilot, please send us an email.