Results “above expectations” for the program of the Italian lung screening network (Risp). With a total of 21,510 registered, of which 10,865 were eligible and 9,131 people underwent lung screening with low-dose radiation CT (LDCT), the results exceeded the expectations of the 7,300 people expected. These are some of the data from the assessment made this morning by the experts who spoke in Rome, at the Ministry of Health, at the institutional event ‘The lung at the center of prevention: an Italian reality’.
“The strategic objective of the Risp program – explains Ugo Pastorino, director of the SC Thoracic Surgery of the National Cancer Institute (Int) of Milan and responsible for the Risp project – is to implement a tumor screening program throughout the national territory lung cancer with Ldct, through a network of centers with high multidisciplinary clinical expertise, with the aim of obtaining a significant reduction in mortality from lung cancer in heavy smokers (from 40% to 50%) and, potentially, also for other pathologies caused by smoking. All through an early diagnosis system that uses chest LDCT with variable periodicity, based on the individual risk of each subject. The Risp program has obtained a higher number of participants than expected”. The set target assigned by the Ministry of Health, of 7,300 total people, was exceeded.
“18 centers in 15 regions throughout Italy were involved, but the hope is to reach at least one center per region”, underlines Daniela Galeone, director of Office 8 Health promotion and prevention and control of chronic degenerative diseases of the former general directorate of Health Prevention of the Ministry of Health. The enrollment of patients (heavy smokers at high risk of lung cancer) – it was recalled during the event – is taking place through the local involvement of pharmacies, family doctors and a simple app that allows patients to do request. In detail, the protocol developed with the Regions provides for a smoking cessation program and an integrated multidisciplinary team (oncologists, radiologists, etc.). In order to increase compliance, all CT scans are read with an artificial intelligence system which allows for uniform reading and helps the radiologist. This also made it possible to obtain a quantification of coronary damage and the level of chronic obstructive pulmonary disease (COPD), which can be used to increase the benefit of prevention.
The majority of subjects screened in the Risp are active smokers and many of them have joined the cessation process with the help of pharmacological support. The Risp therefore entrusted the preparation of an industrial galenic product based on cytisine to a pharmaceutical company and the Int took on the financial burden of producing 1.2 million tablets, to be offered free of charge to 6 thousand active smokers who will accept pharmacological support in all Resp. centers. The distribution of the cytisine packs began this month, in the quantities requested by the different centers.
Now the Risp promoters ask to continue to carry out this virtuous program. In particular, they ask for additional funding of 1 million euros by 31 December 2024: it would allow the Risp program to add an initially planned number of 10 thousand people, evaluate the feasibility and effectiveness of a lung screening program, and possibly extend the screening also to other realities where it does not exist (for example Sardinia).
“It would be important for Italy to also include lung cancer screening in the essential levels of care for certain at-risk patients, starting from 2026”, concludes Pastorino.
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