� Current screening guidelines and eligibility criteria can miss more than 30 % to 50 %, even in smokers .
� A strategy for reducing lung cancer mortality is needed to identify high-risk non-smokers and offer them ( LDCT ) screening .
� Developing such a strategy requires assembling risk factors into a risk prediction model .
� “ We need a different strategy for lung cancer screening ,” he said . “ We know from NLST and NELSON that LDCT screening has a mortality benefit in lung cancer . One major benefit is stage shift to early-stage disease . However , randomized lung cancer screening trials all looked at smokers . From our previous study , we know less than 20 % of our lung cancer patients were eligible for LDCT cancer screening based on NLST study criteria .” ( Table 2 )
Table 2
While developing an accurate risk predication model for patients who have never smoked will be challenging , researchers have made progress as demonstrated in the TALENT ( Taiwan Lung Cancer Screening for Never Smoker Trial ) study , which Dr . Chang reviewed during his lecture .
TALENT used a nationwide LDCT lung cancer screening campaign for this population . Although participants had never smoked , they did to have one or more of the following risks :
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Family history of lung cancer within the third-degree Passive smoking exposure Tuberculosis or chronic obstructive pulmonary disease
Cooking index score ≥ 110 ( measured by number of times per week cooking included pan-frying , stir-frying , or deepfrying multiplied by number of years spent cooking )
Cooking without ventilation