Globally, lung cancer is the leading cause of cancer death. Previous trials demonstrated that low-dose computed tomography lung cancer screening of high-risk individuals can reduce lung cancer mortality by 20% or more. Lung cancer screening has been approved by major guidelines in the United States, and over 4,000 sites offer screening. Adoption of lung screening outside the United States has, until recently, been slow. Between June 2017 and May 2019, the Ontario Lung Cancer Screening Pilot successfully recruited 7,768 individuals at high risk identified by using the PLCOm2012noRace lung cancer risk prediction model. In total, 4,451 participants were successfully screened, retained and provided with high-quality follow-up, including appropriate treatment. In the Ontario Lung Cancer Screening Pilot, the lung cancer detection rate and the proportion of early-stage cancers were 2.4% and 79.2%, respectively; serious harms were infrequent; and sensitivity to detect lung cancers was 95.3% or more. With abnormal scans defined as ones leading to diagnostic investigation, specificity was 95.5% (positive predictive value, 35.1%), and adherence to annual recall and early surveillance scans and clinical investigations were high (>85%). The Ontario Lung Cancer Screening Pilot provides insights into how a risk-based organized lung screening program can be implemented in a large, diverse, populous geographic area within a universal healthcare system.

在全球范围内，肺癌是癌症死亡的主要原因。此前的试验表明，对高危人群进行低剂量计算机断层扫描肺癌筛查可以将肺癌死亡率降低20%或更多。肺癌筛查已获得美国主要指南的批准，超过 4,000 个站点提供筛查服务。直到最近，美国以外地区肺部筛查的采用一直进展缓慢。 2017年6月至2019年5月期间，安大略省肺癌筛查试点成功招募了7,768名利用PLCOm2012noRace肺癌风险预测模型识别出的高风险个体。总共 4,451 名参与者被成功筛选、保留并获得高质量的随访，包括适当的治疗。在安大略省肺癌筛查试点中，肺癌检出率和早期癌症比例分别为2.4%和79.2%；严重伤害并不常见；检测肺癌的敏感性为95.3%或更高。将异常扫描定义为导致诊断调查的扫描，特异性为 95.5%（阳性预测值为 35.1%），并且对年度召回、早期监测扫描和临床调查的遵守率很高（>85%）。安大略省肺癌筛查试点项目提供了关于如何在全民医疗保健系统内的大型、多样化、人口稠密的地理区域实施基于风险的有组织的肺部筛查计划的见解。