Lung cancer screening: implementation, personalization, and future directions

Lung cancer screening with low-dose computed tomography (LDCT) has been shown to reduce lung cancer-specific mortality among individuals at high risk, primarily identified on the basis of age and tobacco smoking history. Over the past decades, randomized trials, feasibility studies, and national or regional initiatives have defined the role of LDCT and shifted the focus from demonstrating efficacy to addressing the challenges of real-world implementation.As programs expand, new needs have emerged. These include effective tobacco cessation interventions, the management of incidental findings, better recruitment and adherence, and equitable access across populations and healthcare systems. Current eligibility criteria remain imperfect and may exclude people at increased risk, which highlights the need for more refined individual risk assessment. Increasing attention is therefore directed toward personalized screening. Risk-prediction models, blood-based biomarkers, liquid biopsy, and other clinical or molecular factors are being investigated to identify those most likely to benefit. Artificial intelligence is also reshaping the field, with tools supporting nodule detection and characterization, volumetric assessment, malignancy risk estimation, and individualized follow-up.Screening is at very different stages across the world. Some regions are moving from trials and pilots to national programs, while others are only beginning to assess feasibility, and health systems, risk profiles, and resources vary widely. Robust evidence from diverse regions and populations is essential to support effective, sustainable, and equitable implementation everywhere.With this Research Topic, we aim to bring together evidence on the current implementation and future development of lung cancer screening across all continents. We welcome Original Research, Reviews, Systematic Reviews, Perspectives, and other relevant contributions addressing, but not limited to:- Screening initiatives and implementation models in individual countries, regions, or cross-national settings, including region-specific experiences from any continent;- Social, economic, organizational, and health policy implications, including long-term sustainability and cost-effectiveness;- Strategies to improve participation, adherence, and equitable access;- Integration of tobacco cessation and other preventive strategies within screening programs;- Management and clinical implications of incidental findings detected during LDCT screening;- Risk-prediction models and approaches to refine or expand current eligibility criteria;- Liquid biopsy, circulating biomarkers, and other molecular approaches for risk stratification and personalization;- Artificial intelligence-based approaches for nodule detection, characterization, risk stratification, and screening management;- Long-term outcomes, potential harms, and broader implications of screening programs.Please note: manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal.The Topic Editors did not declare any potential competing interests in relation to the Research Topic theme. Topic editors: Massimiliano Cani, Georgia Hardavella Source: https://www.frontiersin.org/research-topics/86726/lung-cancer-screening-implementation-personalization-and-future-directions