Lung cancer screening (LCS) with low-dose computed tomography (LDCT) was
demonstrated in the National Lung Screening Trial (NLST) to reduce mortality from the disease.
European mortality data has recently become available from the Nelson randomised controlled
trial, which confirmed lung cancer mortality reductions by 26% in men and 39–61% in women.
Recent studies in Europe and the USA also showed positive results in screening workers exposed to
asbestos. All European experts attending the “Initiative for European Lung Screening (IELS)”—a
large international group of physicians and other experts concerned with lung cancer—agreed that
LDCT-LCS should be implemented in Europe. However, the economic impact of LDCT-LCS and
guidelines for its effective and safe implementation still need to be formulated. To this purpose, the
IELS was asked to prepare recommendations to implement LCS and examine outstanding issues.
A subgroup carried out a comprehensive literature review on LDCT-LCS and presented findings at
a meeting held in Milan in November 2018. The present recommendations reflect that consensus
was reached
