Simplified criteria in lung cancer screening programs

Some current lung cancer screening programs have simplified inclusion criteria, limited to age over 55 years and significant exposure to tobacco smoke. Do you think such criteria are appropriate?

Julian Dobranowski: The risk of that is focusing on a high-risk community subset that is very easy to approach. When we talk about an organized program, the responsibility of that organized program is to include everybody that is at high risk, so that is not only the businessmen that are smoking but also the marginalized populations, some of the less fortunate populations. The pilot studies that we are starting in Ontario are focusing on models of reaching out to those communities. I know that in the UK they are also looking at models of reaching out to those less fortunate communities – and how you actually incorporate them into the program and how you protect them – as well as the ones that are more well-off.