Results of a Swiss community-based pilot study on low-dose ct lung cancer screening.

backgroundLung cancer remains the leading cause of cancer-related mortality worldwide, with early detection playing a crucial role in reducing both deaths and healthcare costs. In Switzerland, the Swiss Cancer Screening Committee has conditionally recommended lung cancer screening using low-dose computed tomography (LDCT). Building on prior national experiences, we conducted a pilot study in Ticino to assess recruitment strategies, infrastructure suitability, and facility availability for a potential screening program.

methodsA single round of LDCT was offered to at-risk individuals based on established inclusion criteria (age and smoking exposure, and/or 6-year lung cancer risk). General practitioners (GPs) played a central role in identifying and referring participants, ensuring a more targeted recruitment strategy. Participants were referred to community hospitals trough a dedicated and homogenous pathway involving lung cancer specialists. Visits results and structured CT reports were shared with GPs, and multidisciplinary recommendations were issued in case of suspicious findings. Clinical and psycho-social characteristics of participants were recorded and analyzed.

resultsOver a four-month period, 100 participants were enrolled, with a median lung cancer risk of 3.3% (IQR 2.1–5.6) and a mean smoking history of 42.2 pack-years (IQR 35.9–53.7). Mean age was 63 years, 69% were male and 86% were active smokers. Scattered distribution compared to general population was observed in educational level. The LDCT detected pulmonary nodules in 44% of participants (30% category 1–2, 10% category 3, 4% category 4A), with 32% requiring follow-up imaging (12 LDCT at 12 months, 10 LDCT at 6 months, 2 LDCT at 3 months and 2 PET scans). One case of early-stage lung cancer was identified at baseline scan and 2 at follow-up (lung cancer detection rate 3%); all successfully treated.

conclusionsCompared to previous Swiss studies, our GP-driven approach enabled rapid recruitment and may improve accessibility, particularly for non-urban populations. However, disparities in educational backgrounds among participants suggest that further refinements in outreach strategies are needed. Additionally, the study highlighted the feasibility of integrating LDCT screening within Ticino’s existing healthcare infrastructure, benefiting from its decentralized hub-and-spoke model. These findings provide valuable insights for future lung cancer screening programs in Switzerland, emphasizing the importance of primary care engagement, geographic accessibility, and tailored recruitment strategies to enhance effectiveness and equity.