CAR/CSTR Practice Guideline on CT Screening for Lung Cancer

Abstract

Lung cancer is the second-most diagnosed cancer and the leading cause of cancer-related death in Canada. The updated CAR/CSTR Practice Guideline on CT Screening for Lung Cancer reflects advancements in evidence since the 2016 guideline, including findings from the NELSON trial and preliminary data from multiple provincial lung cancer screening programs, and aims to support Canadian diagnostic imaging departments in implementing organized lung cancer screening programs. The guideline emphasizes screening with the use of low-dose CT (LDCT) to reduce lung cancer mortality in appropriately selected individuals with increased risk of lung cancer, using eligibility criteria based on risk prediction models such as the PLCO_m2012. It outlines training requirements for radiologists, standardized CT and reporting protocols, quality assurance measures, and the integration of AI tools for nodule risk stratification. The document also highlights emerging areas for investigation, including the potential for biennial screening and equitable access to programs across Canada.

Keywords: CT; guideline; low dose; lung cancer; protocols; screening.