Quality, Standards, and Optimal Training of Radiologists for Lung Cancer Screening.

Abstract

Lung cancer screening (LCS) with low-dose computed tomography (LDCT) has been shown to detect lung cancer at an earlier stage and to reduce mortality among high-risk populations, as demonstrated by major trials including I-ELCAP, NLST, and NELSON. These findings have led to the implementation of national screening programs worldwide. This article outlines the critical components required for the successful implementation of high-quality LCS programs, with a particular focus on quality assurance (QA) mechanisms and radiologist training. Structured radiologist training is essential to ensure the accuracy and effectiveness of LDCT screening. As these requirements are universal, online initiatives such as the I-ELCAP Teaching File, ESTI Lung Cancer Certification Project, and the UK's PERFECTS EQA platform provide scalable models for enhancing radiologic performance in LCS. The success of lung cancer screening programs depends not only on access and infrastructure but also on rigorous training and quality oversight. International collaboration and the adoption of validated educational and QA tools are key to optimizing outcomes and maintaining diagnostic excellence in LDCT-based screening.