[White paper on identification, information, and eligibility assessment of potential participants in lung cancer screening in Germany].

Abstract

Abstract: The nationwide introduction of lung cancer screening using low-dose computed tomography (LDCT) is imminent in Germany. In contrast to other cancer screening programs, lung cancer screening follows a risk-based approach and specifically targets heavy current and former smokers aged 50 to 75 years. Following several years of pilot phases and regulatory preparation, the Federal Joint Committee (G-BA) decided in June 2025 to include this program as a regular benefit covered by statutory health insurance starting in 2026.Evidence from large international studies demonstrates a significant reduction in lung cancer mortality of approximately 20%. However, there are also risks such as overdiagnosis, unnecessary invasive procedures in false-positive findings, secondary cancers due to radiation exposure, and psychological burden.Key factors for program success include the structured involvement of qualified physicians in the identification, information, and assessment of eligibility of potential participants. Physicians in the fields of general medicine, occupational medicine, and internal medicine have been authorized after specific qualification, the latter of which includes pulmonologists - who, while not explicitly mentioned, will certainly have the closest contact with the high-risk population of smokers. This white paper provides practical information and materials for participating in lung cancer screening. It highlights the importance of dedicated interdisciplinary collaboration to detect as many lung cancer patients as possible at an early and therefore potentially curable stage.