CCM-ITALUNG2 pilot on lung cancer screening in Italy: recruitment, integration with smoking cessation and baseline results

Background: The CCM-ITALUNG2 pilot was implemented to evaluate the feasibility of an organized lung cancer (LC) screening programme in five Italian centres. Methods: The screening pathway included invitation, recruitment, referral to Smoking Cessation Services (SCSs), and use of the Lung-RADS score for low-dose CT reading. Dedicated screening operators followed up participants from recruitment through the clinical follow-up established by multidisciplinary teams. Eligibility criteria included age 55-75 years, ever-smokers with ≥ 25 pack-years; quit within the past 10 years. Baseline round results are presented. Results: From November 2022 to May 2024, 1,144 of the 1,971 invited individuals (58.0%) were recruited following different strategies including in-person invitation by general practitioners (GPs; 356 subjects, 31.9%) or other healthcare personnel (18.1%), self-presentation (36.3%), and phone invitation using GPs' patient lists (13.7%). Among current smokers, 38.5% accepted referral to SCSs. Eighteen subjects (77.8% in stage I-II) were diagnosed with LC (prevalent LC rate 1.57%). The mean time to surgery was 147 days (standard deviation 73); the false-positive rate was 1.38% (15/1,085). Conclusions: By utilizing different organizational models, the pilot was tailored to the specific characteristics of each centre. Phone invitations from GPs' patient lists, in-person invitations by GPs and other healthcare personnel, and self-presentation might enhance equity of access in comparison with self-referral only. Dedicated screening operators, the use of the Lung-RADS scoring system, and a structured clinical follow-up supported participants throughout the screening pathway. Delivering brief advice for smoking cessation during recruitment and offering SCS referral were feasible within the screening pathway.