The aim of this study is to evaluate and optimize entry criteria for the proposed programme for early detection of lung cancer in the Czech Republic.

An estimated 3200 high-risk (age 55-74 years, >30 pack-years) asymptomatic individuals will undergo baseline low-dose chest CT (LDCT) and a follow-up LDCT at 1 year. Patients with poor performance status (PS) 2-4, history of malignancy in the past 10 years, chest CT in the past 1 year, bodyweight >140kg will not be included.

The patients will fill out a questionnaire with basic data, including smoking history (pack-years), history of previous malignancy, CT imaging of the thorax, and will undergo spirometry.

Outcomes of the study include:

• optimization of entry criteria, optimization of timing of a follow-up LDCT and management of the patients, proposal of quality assurance indicators
• influence of screening on the stage of lung cancer at the time of the diagnosis and life-years lost
• cost-effectiveness of the screening program
• evaluation of the diagnostic yield for secondary findings (pulmonary fibrosis, cardiovascular risk)

Inclusion Criteria:

• Age 55-74 years
• Smoking: >= 30 pack-years, smoker or ex-smoker <15 years
• Performance status (0-1) - can climb at least one floor without any difficulty or pause

Exclusion Criteria:

• Body weight above 140 kg
• Malignant disease within the last 10 years (except non-melanoma skin cancer).
• Chest CT less than one year ago
• Clinical signs suspicious of lung cancer (weight loss, new cough, hemoptysis)

Defined by eligibility criteria

There is no plan to share individual participant data.