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IARC Says Low-Dose CT Can Cut Lung Cancer Deaths: AIIMS Expert Explains Why India Needs Its Own Screening Evidence

Low-dose CT (LDCT) screening of people at high risk based on age and smoking history can reduce <span><a href="https://www.healthandme.com/health/lung-cancer">lung cancer</a></span> deaths and advanced-stage disease, according to an International Agency for Research on <span><a href="https://www.healthandme.com/health/cancer">Cancer</a></span> (<span>IARC</span>) working group.

Speaking to <strong><em>HealthandMe</em></strong>, <span>Dr Abhishek Shankar</span> of AIIMS New Delhi, the only <span>India</span>n author among the 23 experts from 17 countries involved in the IARC review, said India needs to generate its own screening evidence.

The review was published in The New England Journal of Medicine as part of <span>IARC WHO Handbook 21</span>.

<h2>India Should Not Wait For A Perfect Model</h2>

Dr Shankar, a lung cancer specialist, said India needs to generate its own screening evidence while ensuring high-risk people have access to screening and follow-up care.

“India should not wait for a perfect screening model and there is a need to generate Indian evidence while ensuring that those at highest risk have access to <span>lung cancer screening</span> and care pathways for screen positive cases,” he said.

Dr Shankar is leading the Indian Lung Screening Trial (ILST), which is assessing risk-based <a href="https://www.healthandme.com/health-news/us-cancer-death-rates-fall-for-men-women-lung-cancer-progress-drives-decline-article-156215533" data-type="tilCustomLink">lung cancer</a> screening across 10 centers in India.

<strong>Also read: </strong><a href="https://www.healthandme.com/health-news/never-smoked-still-got-lung-cancer-rare-mutation-linked-to-over-60x-risk-article-156182327" data-type="tilCustomLink">Never Smoked, Still Got Lung Cancer? Rare Gene Mutation Linked To Over 60x Risk</a> 

<h2>Who Should Undergo LDCT Screening?</h2>

The evidence mainly covers people aged 50 to 80 with a substantial smoking history, typically 20–30 pack-years or more. Studies involving former smokers generally included those who had quit within the previous 10–15 years.

In India, people aged 50 to 80 who have smoked at least 20 pack-years and are current smokers or quit within the past 15 years can contact ILST about screening under the trial.

“High-risk smokers should be encouraged to participate in organized screening rather than opportunistic CT scanning, with appropriate nodule management, follow-up and smoking-cessation support,” Dr Shankar said.

<strong>Read More: </strong><a href="https://www.healthandme.com/health-wellness/world-lung-day-dry-cough-breathlessness-may-not-always-be-asthma-could-it-be-ild-article-156224514" data-type="tilCustomLink">World Lung Day: Dry Cough, Breathlessness May Not Always Be Asthma — Could It Be ILD?</a>

In the US National Lung Screening Trial, LDCT was linked to a 16% lower relative risk of lung cancer death at seven years compared with chest X-rays. The European NELSON trial also found lower lung cancer mortality among men screened with LDCT at 10 years.

IARC classified LDCT as Group A, indicating established evidence that it reduces lung cancer mortality and stage III or IV disease. Chest X-rays, with or without sputum examination, were classified as Group C, as a mortality benefit could not be established.

<h2>What Are The Risks Of LDCT Screening?</h2>

How to Protect Your Lungs From Childhood to Old Age | World Lung Day

LDCT is not meant for everyone. Across studies, false-positive rates ranged from 1% to 42%. Among those with false-positive results, 5% to 32% underwent an invasive procedure, with complications reported in 10% to 22% of those procedures.

The review also estimated that 3% to 26% of lung cancers detected in randomized trials could represent over-diagnosis.

The IARC group stressed that screening requires more than CT scans, including risk assessment, nodule management, follow-up, smoking-cessation support and adequate healthcare capacity.

“India has an opportunity to build an equitable, affordable, locally relevant lung cancer screening pathway and ILST can provide the evidence needed to guide that future,” Dr Shankar said.

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Low-dose CT (LDCT) screening of people at high risk based on age and smoking history can reduce lung cancer deaths and advanced-stage disease, according to an International Agency for Research on Cancer (IARC) working group.Speaking to HealthandMe, Dr Abhishek Shankar of AIIMS New Delhi, the only Indian author among the 23 experts from 17 countries involved in the IARC review, said India needs to generate its own screening evidence.The review was published in The New England Journal of Medicine as part of IARC WHO Handbook 21.India Should Not Wait For A Perfect ModelDr Shankar, a lung cancer specialist, said India needs to generate its own screening evidence while ensuring high-risk people have access to screening and follow-up care.“India should not wait for a perfect screening model and there is a need to generate Indian evidence while ensuring that those at highest risk have access to lung cancer screening and care pathways for screen positive cases,” he said.Dr Shankar is leading the Indian Lung Screening Trial (ILST), which is assessing risk-based lung cancer screening across 10 centers in India.Also read: Never Smoked, Still Got Lung Cancer? Rare Gene Mutation Linked To Over 60x Risk Who Should Undergo LDCT Screening?The evidence mainly covers people aged 50 to 80 with a substantial smoking history, typically 20–30 pack-years or more. Studies involving former smokers generally included those who had quit within the previous 10–15 years.In India, people aged 50 to 80 who have smoked at least 20 pack-years and are current smokers or quit within the past 15 years can contact ILST about screening under the trial.“High-risk smokers should be encouraged to participate in organized screening rather than opportunistic CT scanning, with appropriate nodule management, follow-up and smoking-cessation support,” Dr Shankar said.What Did The Trials Show?Read More: World Lung Day: Dry Cough, Breathlessness May Not Always Be Asthma — Could It Be ILD?In the US National Lung Screening Trial, LDCT was linked to a 16% lower relative risk of lung cancer death at seven years compared with chest X-rays. The European NELSON trial also found lower lung cancer mortality among men screened with LDCT at 10 years.IARC classified LDCT as Group A, indicating established evidence that it reduces lung cancer mortality and stage III or IV disease. Chest X-rays, with or without sputum examination, were classified as Group C, as a mortality benefit could not be established.What Are The Risks Of LDCT Screening?   LDCT is not meant for everyone. Across studies, false-positive rates ranged from 1% to 42%. Among those with false-positive results, 5% to 32% underwent an invasive procedure, with complications reported in 10% to 22% of those procedures.The review also estimated that 3% to 26% of lung cancers detected in randomized trials could represent over-diagnosis.The IARC group stressed that screening requires more than CT scans, including risk assessment, nodule management, follow-up, smoking-cessation support and adequate healthcare capacity.“India has an opportunity to build an equitable, affordable, locally relevant lung cancer screening pathway and ILST can provide the evidence needed to guide that future,” Dr Shankar said.

iarc says low-dose ct can cut lung cancer deaths: aiims expert explains why india needs its own screening evidence

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