Korean J Health Promot KJHP Korean Journal of Health Promotion 2234-2141 2093-5676 Korean Society for Health Promotion and Disease Prevention 10.15384/kjhp.2019.19.4.161 Review Article Evidence of National Lung Cancer Screening Program in Korea https://orcid.org/0000-0003-1142-1559 Kim Yeol National Cancer Center, Goyang, Korea. Corresponding author: Yeol Kim, MD, MPH, PhD. National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea. Tel: +82-31-920-1753, Fax: +82-31-920-2189, drheat@ncc.re.kr 12 2019 31 12 2019 19 4 161 165 25 11 2019 05 01 2020 06 01 2020 Copyright © 2019 Korean Society for Health Promotion and Disease Prevention 2019 Korean Society for Health Promotion and Disease Prevention This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Lung cancer is a leading cause of cancer death worldwide. The effectiveness of lung cancer targeted high-risk population using low dose chest computed tomography has been reported several randomized controlled trials. Thus, recently, lung cancer screening to high-risk group is recommended internationally. National Cancer Center reported a lung cancer screening guideline by evidence-based methods in 2015. Korean national lung cancer screening program started from 2019 after evaluation of Korean lung cancer screening demonstration project (K-LUCAS) nationwide. K-LUCAS obtained comparable high early lung cancer detection rate, lower false positive rate and lower complication rate compared with clinical trials conducted in other countries. Also psychological anxiety of screening participants had been low, but willingness of smoking cessation had been increased after screening. This paper will review the evidence of lung cancer screening from clinical trials, also, evaluate the benefits and harms of screening based on K-LUCAS.

 Lung cancer Screening Low-dose computed tomography False positive Overdiagnosis World Health Organization (WHO) Cancer Fact [Internet] Geneva WHO 2018 Accessed Nov 1, 2019 Available from: https://www.who.int/news-room/fact-sheets/detail/cancer National Cancer Information Center Cancer statistics [Internet] Goyang National Cancer Information Center 2016 Accessed Nov 1, 2019 Available from: https://www.cancer.go.kr/lay1/S1T639C640/contents.do National Lung Screening Trial Research Team Aberle DR Adams AM Berg CD Black WC Clapp JD Reduced lung-cancer mortality with low-dose computed tomographic screening New Engl J Med 2011 365 5 395 409 Jang SH Sheen S Kim HY Yim HW Park BY Kim JW The Korean guideline for lung cancer screening J Korean Med Assoc 2015 58 4 291 301 Lee J Lim J Kim Y Kim HY Goo JM Lee CT Development of Protocol for Korean Lung Cancer Screening Project (K-LUCAS) to evaluate effectiveness and feasibility to implement national cancer screening program Cancer Res Treat 2019 51 4 1285 1294 National Cancer Center Report of Korean lung cancer screening demonstration project results Goyang National Cancer Center 2018 Horeweg N van Rosmalen J Heuvelmans MA van der Aalst CM Vliegenthart R Scholten ET Lung cancer probability in patients with CT-detected pulmonary nodules: a prespecified analysis of data from the NELSON trial of low-dose CT screening Lancet Oncol 2014 15 12 1332 1341 Pinsky PF Gierada DS Black W Munden R Nath H Aberle D Performance of Lung-RADS in the national lung screening trial: a retrospective assessment Ann Intern Med 2015 162 7 485 491 Pastorino U Silva M Sestini S Sabia F Boeri M Cantarutti A Prolonged lung cancer screening reduced 10-year mortality in the MILD trial: new confirmation of lung cancer screening efficacy Ann Oncol 2019 30 7 1162 1169 National Lung Screening Trial Research Team Lung cancer incidence and mortality with extended follow-up in the national lung screening trial J Thorac Oncol 2019 14 10 1732 1742 Lazris A Roth AR Lung cancer screening: pros and cons Am Fam Physician 2019 99 12 740 742 NHS England Targeted Screening for Lung Cancer with Low Radiation Dose Computed Tomography [Internet] Redditch NHS England 2019 Accessed Nov 1, 2019 Available from: https://www.england.nhs.uk/publication/targeted-screening-for-lung-cancer Summary of important outcomes of studies on population-based lung cancer screening

Abbreviation: DANTE, Detection and Screening of Early Lung Cancer by Novel Imaging Technology and Molecular Essays Trial; DLST, Danish Lung Cancer Screening Trial; LUSI, German Lung Cancer Screening Intervention Trial; MILD, Multi-centric Italian Lung Detection; NA, non applicable; NELSON, Dutch-Belgian Randomized Lung Cancer Screening Trial; NLST, National Lung Screening Trial; UKLS, United Kingdom Lung Screen.

 Evaluation list of Korean lung cancer screening demonstration project