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Introduction: Lung cancer screening (LCS) using low-dose-computed tomography reduces lung cancer mortality in high-risk individuals. Evaluating and monitoring LCS programs are important to ensure and improve quality, efficiency and participant outcomes. There is no agreement on LCS quality indicators (QIs)., Methods: Twenty multidisciplinary members of IASLC used a Delphi process to develop consensus Qis. They considered 50 Qis during information/discussion sessions and two anonymous voting rounds. ≥80% voting agree/strongly agree on a five-point Likert scale determined consensus., Results: Twenty essential and six desirable QIs were identified in 10 of 11 LCS pathway domain categories: ENTRY: Proportion eligible who got screened. SMOKING_CESSATION: Proportion current-smoking individuals offered cessation interventions., Imaging: Proportion screened requiring clinical diagnostic assessment, scans results distribution, proportion scans requiring early follow-up, proportion baseline/regular scans with actionable additional findings., Adherence to: Annual/regular scans, early interim scans, clinical diagnostic assessment., Diagnostic: Proportion suspicious-for-lung-cancer scans receiving clinical investigation, undergoing invasive diagnostic procedures., Outcomes: Cancer detection rate, stage distribution, interval cancer rate HARMS: Number/proportion of serious complications following invasive procedures, non-lung cancer diagnoses following invasive procedures, or following surgery, 30-day mortality following invasive procedure., Treatment: Proportion early-stage cancers receiving treatment with curative intent. WAIT_TIMES: Suspicious-for-lung-cancer scan to definitive diagnosis, curative-intent treatment for individuals with early-stage disease, scan completion to reporting results to PCP/participant., Equity: Race/sex/socioeconomic differences in adherence to regular screens, early-stage cancer treatment, offer of smoking cessation interventions, clinical investigation of suspicious-for-lung-cancer screens., Discussion: Review among panel members provide recommended LCS QIs that should be considered in development of LCS initiatives ., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: To facilitate global implementation of lung cancer (LC) screening and early detection in a quality assured and consistent manner, common terminology is needed. Researchers and clinicians within different specialties may use the same terms but with different meanings or different terms for the same intended meanings., Methods: The Diagnostics Working Group of the International Association for the Study of Lung Cancer Early Detection and Screening Committee has analyzed and discussed relevant terms used on a regular basis and suggests recommendations for consensus definitions of terminology applicable in this setting. We explored how to reach consensus to define relevant and unambiguous terminology for use by health care providers, researchers, patients, screening participants, and family., Results: Terms and definitions for epidemiologic and health-economical purposes included the following: standardized incidence and mortality rates, LC-specific survival, long-term survival and cure rates, overdiagnosis, overtreatment, and undertreatment. Terms and definitions for defining screening findings included the following: positive, false-positive, negative, false-negative, and indeterminate findings and additional and incidental findings. Terms and definitions for describing parameters in screening programs included the following: opportunistic versus programmatic screening, screening rounds, interval or interim diagnoses, and invasive and minimally invasive procedures. Terms and definitions for shared decision-making included the following: LC screening-possible harms and risks and LC risk and modifiers prior and posterior to a measure., Conclusions: A common set of terminology with standard definitions is recommended for describing clinical LC screening programs, the discussion about effectiveness and outcomes, or the clinical setting. The use of the terms should be clearly defined and explained., Competing Interests: Disclosure Dr. Huber participated in advisory boards for Janssen Germany, Merck Germany, Boehringer Ingelheim, Sanofi Germany, Novocure Germany Advisory, is deputy chair of the Early detection and screening committee of IASLC and co-chair of the ERS/ESTS task force Fitness for therapy of lung cancer. Dr. Kitts gets consulting fees from City of Hope, American College of Radiology and Memorial Sloan Kettering and support for attending meetings from Rescue Lung Society and American Cancer Society. Dr. Kitts has patents for Community based Individualized Health Platforms and Individualized Health Platforms, issued to Prosumer Health Founders and leadership roles in Rescue Lung Society, Lung Cancer Policy Network and Prosumer Health (start-up company) and stocks of Johnson & Johnson, Abbvie and Abbot Labs. Dr. Henschke serves on advisory board for Lunglife AI. without compensation and is a named inventor on a number of patents and patent applications relating to the evaluation of pulmonary nodules on CT scans of the chest which are owned by Cornell Research Foundation (CRF). Since 2009, Dr. Henschke does not accept any financial benefit from these patents including royalties and any other proceeds related to the patents or patent applications owned by CRF. Dr. Henschke is the President and serves on the board of the Early Diagnosis and Treatment Research Foundation. She receives no compensation from the Foundation. The Foundation is established to provide grants for projects, conferences, and public databases for research on early diagnosis and treatment of diseases. Recipients include, I-ELCAP, among others. The funding comes from a variety of sources including philanthropic donations, grants and contracts with agencies (federal and non-federal), imaging and pharmaceutical companies relating to image processing assessments. The various sources of funding exclude any funding from tobacco companies or tobacco-related sources. Dr. Lam got travel support from IASLC to attend World Conference on Lung Cancer and from the Canadian Partnership Against Cancer and is on its advisory aboard as well as for Nucleix Technologies Inc Medical. Dr. Kazerooni is on the advisory board of the International Lung Screening Trial. Dr. Kerpel-Fronius is on the speaker bureau of Boehringer Ingelheim and MSD. Dr. Yankelevitz owns equity in HeartLung and is on advisory boards for HeartLung, Median Technology, Carestream and Lunglife AI. Dr. Yankelevitz is a named inventor on a number of patents and patent applications related to the evaluation of chest diseases including measurements of chest nodules. Dr. Yankelevitz has received financial compensation for the licensing of these patents. He is consultant and co-owner of Accumetra. The remaining authors declare no conflict of interest., (Copyright © 2024 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)

Introduction: Targeted low-dose CT lung cancer screening reduces lung cancer mortality. England's Targeted Lung Health Check programme uses risk prediction tools to determine eligibility for biennial screening among people with a smoking history aged 55-74. Some participants initially ineligible for lung cancer screening will later become eligible with increasing age and ongoing tobacco exposure. It is, therefore, important to understand how many people could qualify for reinvitation, and after how long, to inform implementation of services., Methods: We prospectively predicted future risk (using Prostate, Lung, Colorectal and Ovarian trial's risk model (PLCO m2012 ) and Liverpool Lung Project version 2 (LLP v2 ) risk models) and time-to-eligibility of 5345 participants to estimate how many would become eligible through the course of a Lung Health Check screening programme for 55-74 years., Results: Approximately a quarter eventually become eligible, with those with the lowest baseline risks unlikely to ever become eligible. Time-to-eligibility is shorter for participants with higher baseline risk, increasing age and ongoing smoking status. At a PLCO m2012 threshold ≥1.51%, 68% of those who continue to smoke become eligible compared with 18% of those who have quit., Discussion: Predicting which participants may become eligible, and when, during a screening programme can help inform reinvitation strategies and service planning. Those with risk scores closer to the eligibility threshold, particularly people who continue to smoke, will reach eligibility in subsequent rounds while those at the lowest risk may be discharged from the programme from the outset., Competing Interests: Competing interests: RB has received honoraria for educational events by Siemens Healthineers and Cobalt Medical Imaging., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Chronic pulmonary aspergillosis (CPA) is a rare but significant complication of lung cancer surgery. Its effect on survival remains unclear. Our aim was to describe the outcomes of the patients who developed CPA following the surgery for non-small cell lung cancer (NSCLC), identify the risk factors associated with its development following lung resection, and evaluate its impact on survival. All the patients with a diagnosis of CPA and operated NSCLC were identified in the National Aspergillosis Centre (NAC) database (2009-2020). Additional patients were identified in the Northwest Clinical Outcomes Research Registry (2012-2019) database. A regression analysis was performed to examine potential links between CPA and long-term outcomes and also to identify the factors associated with the development of CPA. The primary outcomes were the development of CPA, 1-year and 5-year mortality, and overall survival. Thirty-two patients diagnosed with CPA after lung resection were identified in the NAC database, of which 11 were also contained within the NCORR database, with a prevalence of 0.2% ( n = 11/4425). Post-operative CPA was associated with significantly lower survival on log-rank analysis ( p = 0.020). Mortality at one year was 25.0% ( n = 8) and 59.4% ( n = 19) at five years after the CPA diagnosis. On univariable analysis, a lower mean percentage-predicted forced expiratory volume in 1 s, ischaemic heart disease, and chronic obstructive pulmonary disease were all significantly associated with CPA development. CPA is a rare complication following lung cancer surgery which has a significant impact on long-term survival. Its development may be associated with pre-existing cardiopulmonary comorbidities. Further research in larger cohorts is required to substantiate these findings.