Kapacitet för lungcancerscreening i Sverige, utmaningar och lösningar

Lung cancer is one of the most common cancers; it is also the deadliest form of cancer in terms of number of deaths. During the period 2014–2018, lung cancer was the 4th most common form of cancer in both men and women. Median age at diagnosis is 69 years and estimated relative 5-year survival is approximately 20%. In Sweden, there is currently no national screening program for lung cancer. Previous studies from the Netherlands and the USA have shown that targeted screening for lung cancer reduces mortality related to the disease. Based on this research indicating advantageous results of screening, together with the ambition of Swedish healthcare to offer cancer patients equal and timely treatment, pilot studies of lung cancer screening have been initiated in some regions and their respective regional cancer centers. A prerequisite for successful implementation of a screening program is sufficient capacity in all parts of the health care process. A particular concern is the availability of radiologists for assessment of results from computed tomography, as radiologists are a scarce resource. The purpose of the study is to analyse the conditions for lung cancer screening with a focus on radiology as well as investigating the effect of different screening scenarios on radiology capacity. In Swedish healthcare, AI is being evaluated as a supporting method in different areas including diagnostics. Future possibilities for lung cancer screening could include new methods such as AI. The scenarios for screening in this study are intended to illustrate a possible and gradual development towards a screening process where all Swedish healthcare regions use of AI through a centralized national structure. The scenario development should be seen as a hypothetical and exploratory development of a screening program for lung cancer. At present, more research on AI is needed, including how AI could complement radiology and other areas of the Swedish healthcare system.