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Hoffmann H, Kaaks R, Andreas S, Bauer TT, Barkhausen J, Harth V, Kauczor HU, Pankow W, Welcker K, Vogel-Claussen J, Blum TG. [Statement Paper on the Implementation of a National Organized Program in Germany for the Early Detection of Lung Cancer in Risk Populations Using Low-dose CT Screening Including Management of Screening Findings]. Zentralbl Chir 2024; 149:96-115. [PMID: 37816386 DOI: 10.1055/a-2178-5907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
The process of implementing early detection of lung cancer with low-dose CT (LDCT) in Germany has gained significant momentum in recent years. It is expected that the ordinance of the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) on early detection of lung cancer, which has been commented on by the professional societies, will come into effect by the end of 2023. Based on this regulation, the Federal Joint Committee (G-BA) will set up a program for early lung cancer detection with LDCT in the near future. In this position paper, the specialist societies involved in lung cancer screening present concrete cornerstones for a uniform, structured and quality-assured early detection program for lung cancer in Germany to make a constructive contribution to this process.
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Affiliation(s)
- Hans Hoffmann
- Sektion Thoraxchirurgie, Klinikum rechts der Isar, Technische Universität München, Deutschland
| | - Rudolf Kaaks
- Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
- Translational Lung Research Center Heidelberg, Deutsches Zentrum für Lungenforschung, Deutschland
| | - Stefan Andreas
- Lungenfachklinik Immenhausen, Deutschland
- Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Deutschland
- Deutsches Zentrum für Lungenforschung, Gießen, Deutschland
| | - Torsten T Bauer
- Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Deutschland
| | - Jörg Barkhausen
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland
| | - Volker Harth
- Zentralinstitut für Arbeitsmedizin und Maritime Medizin, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | - Hans-Ulrich Kauczor
- Translational Lung Research Center Heidelberg, Deutsches Zentrum für Lungenforschung, Deutschland
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Deutschland
| | - Wulf Pankow
- Taskforce Tabakentwöhnung, Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, Berlin, Deutschland
| | - Katrin Welcker
- Klinik für Thoraxchirurgie, Kliniken Maria Hilf GmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Deutschland
| | - Jens Vogel-Claussen
- Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Deutschland
- Biomedical Research in Endstage and Obstructive Lung Disease Hanover (BREATH), Deutsches Zentrum für Lungenforschung, Hannover, Deutschland
| | - Torsten Gerriet Blum
- Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Deutschland
- Medical School Berlin, Deutschland
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Vogel-Claussen J, Blum TG, Andreas S, Bauer TT, Barkhausen J, Harth V, Kauczor HU, Pankow W, Welcker K, Kaaks R, Hoffmann H. [Statement paper on the implementation of a national organized program in Germany for the early detection of lung cancer in risk populations using low-dose CT screening including management of screening findings]. ROFO-FORTSCHR RONTG 2024; 196:134-153. [PMID: 37816377 DOI: 10.1055/a-2178-2846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
The process of implementing early detection of lung cancer with low-dose CT (LDCT) in Germany has gained significant momentum in recent years. It is expected that the ordinance of the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) on the early detection of lung cancer, which has been commented on by the professional societies, will come into effect by the end of 2023. Based on this regulation, the Federal Joint Committee (G-BA) will set up a program for early lung cancer detection with LDCT in the near future. In this position paper, the specialist societies involved in lung cancer screening present key points for a uniform, structured and quality-assured early detection program for lung cancer in Germany to make a constructive contribution to this process. CITATION FORMAT: · Vogel-Claussen J, Blum TG, Andreas S et al. Position paper on the implementation of a nationally organized program in Germany for the early detection of lung cancer in high-risk populations using low-dose CT screening including the management of screening findings requiring further workup. Fortschr Röntgenstr 2024; 196: DOI 10.1055/a-2178-2846.
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Affiliation(s)
- Jens Vogel-Claussen
- Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Deutsches Zentrum für Lungenforschung, Hannover, Deutschland
| | - Torsten Gerriet Blum
- Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Deutschland
- Medical School Berlin, Berlin, Deutschland
| | - Stefan Andreas
- Lungenfachklinik Immenhausen, Immenhausen
- Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Deutschland
- Deutsches Zentrum für Lungenforschung, Gießen, Deutschland
| | - Torsten T Bauer
- Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Deutschland
| | - Jörg Barkhausen
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland
| | - Volker Harth
- Zentralinstitut für Arbeitsmedizin und Maritime Medizin, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | - Hans-Ulrich Kauczor
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Deutschland
- Translational Lung Research Center Heidelberg, Deutsches Zentrum für Lungenforschung, Deutschland
| | - Wulf Pankow
- Taskforce Tabakentwöhnung, Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, Berlin, Deutschland
| | - Katrin Welcker
- Klinik für Thoraxchirurgie, Kliniken Maria Hilf GmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Deutschland
| | - Rudolf Kaaks
- Translational Lung Research Center Heidelberg, Deutsches Zentrum für Lungenforschung, Deutschland
- Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - Hans Hoffmann
- Sektion Thoraxchirurgie, Klinikum rechts der Isar, Technische Universität München, Deutschland
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Blum TG, Vogel-Claussen J, Andreas S, Bauer TT, Barkhausen J, Harth V, Kauczor HU, Pankow W, Welcker K, Kaaks R, Hoffmann H. [Statement paper on the implementation of a national organized program in Germany for the early detection of lung cancer in risk populations using low-dose CT screening including management of screening findings]. Pneumologie 2024; 78:15-34. [PMID: 37816379 DOI: 10.1055/a-2175-4580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
The process of implementing early detection of lung cancer with low-dose CT (LDCT) in Germany has gained significant momentum in recent years. It is expected that the ordinance of the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) on early detection of lung cancer, which has been commented on by the professional societies, will come into effect by the end of 2023. Based on this regulation, the Federal Joint Committee (G-BA) will set up a program for early lung cancer detection with LDCT in the near future. In this position paper, the specialist societies involved in lung cancer screening present concrete cornerstones for a uniform, structured and quality-assured early detection program for lung cancer in Germany to make a constructive contribution to this process.
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Affiliation(s)
- Torsten Gerriet Blum
- Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Deutschland
- Medical School Berlin, Berlin, Deutschland
| | - Jens Vogel-Claussen
- Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Deutschland
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Deutsches Zentrum für Lungenforschung, Hannover, Deutschland
| | - Stefan Andreas
- Lungenfachklinik Immenhausen, Immenhausen, Deutschland
- Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Deutschland
- Deutsches Zentrum für Lungenforschung, Gießen, Deutschland
| | - Torsten T Bauer
- Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Deutschland
| | - Jörg Barkhausen
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland
| | - Volker Harth
- Zentralinstitut für Arbeitsmedizin und Maritime Medizin, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | - Hans-Ulrich Kauczor
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Deutschland
- Translational Lung Research Center Heidelberg, Deutsches Zentrum für Lungenforschung, Deutschland
| | - Wulf Pankow
- Taskforce Tabakentwöhnung, Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, Berlin, Deutschland
| | - Katrin Welcker
- Klinik für Thoraxchirurgie, Kliniken Maria Hilf GmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Deutschland
| | - Rudolf Kaaks
- Translational Lung Research Center Heidelberg, Deutsches Zentrum für Lungenforschung, Deutschland
- Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - Hans Hoffmann
- Sektion Thoraxchirurgie, Klinikum rechts der Isar, Technische Universität München, Deutschland
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Vogel-Claussen J, Lasch F, Bollmann BA, May K, Kuhlmann A, Schmid-Bindert G, Kaaks R, Barkhausen J, Bohnet S, Reck M. Design and Rationale of the HANSE Study: A Holistic German Lung Cancer Screening Trial Using Low-Dose Computed Tomography. ROFO-FORTSCHR RONTG 2022; 194:1333-1345. [PMID: 35917826 DOI: 10.1055/a-1853-8291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Despite the high prevalence and mortality of lung cancer and proven effectiveness of low-dose computed tomography (LDCT) to reduce mortality, Germany still lacks a national screening program. The German Institute for Quality and Efficiency in Health Care (IQWiG) and the Federal Office for Radiation Protection (BfS) both published positive scientific evaluations recommending a quality-controlled national screening program. IQWiG underlined the importance of a clear risk definition, integrated smoking cessation programs, and quality assurance, highlighting the necessity of procedural optimization. METHODS AND OBJECTIVES In the HANSE study, former and current smokers aged 55-79 years are assessed for their lung cancer risk by the NELSON and PLCOM2012 risk scores. 5000 high-risk participants, defined as PLCOM2012 6-year risk ≥ 1.58 % or fulfilling NELSON risk inclusion criteria, will be screened by LDCT at baseline and after 12 months. Lung nodules are analyzed by a modified Lung-RADS 1.1 score of the HANSE study, and values of emphysema and coronary calcium are determined and randomly reported to the participants. 7100 low-risk participants serve as a control. All patients are followed-up for up to 10 years. The sensitivity and specificity of the two risk assessments and LDCT screening, effects of the randomized LDCT reporting, efficiency of lung nodule management, and several other factors are assessed to analyze the success and quality of the holistic screening program. CONCLUSION The HANSE study is designed as a holistic lung cancer screening study in northern Germany to answer pressing questions for a successful implementation of an effective German lung cancer screening program. KEY POINTS · HANSE is designed to address pressing questions for the implementation of lung cancer screening in Germany.. · HANSE compares NELSON and PLCOM2012 risk assessments for optimal definition of the high-risk group. . · HANSE integrates cardiac calcium and pulmonary emphysema scoring in a holistic screening approach.. CITATION FORMAT · Vogel-Claussen J, Lasch F, Bollmann B et al. Design and Rationale of the HANSE Study: A Holistic German Lung Cancer Screening Trial Using Low-Dose Computed Tomography. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1853-8291.
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Affiliation(s)
- Jens Vogel-Claussen
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Giessen, Germany
| | - Florian Lasch
- Department of Biostatistics, Hannover Medical School, Hannover, Germany
| | - Benjamin-Alexander Bollmann
- Department of respiratory medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Giessen, Germany
| | - Katharina May
- Department of Radiology and Nuclear Medicine, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Alexander Kuhlmann
- Working Group Health Economics, Martin Luther University Halle Wittenberg, Halle, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Giessen, Germany
| | - Gerald Schmid-Bindert
- Oncology Medical Department, AstraZeneca GmbH, Hamburg, Germany.,Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Rudolf Kaaks
- Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research, Giessen, Germany.,Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Jörg Barkhausen
- Department of Radiology and Nuclear Medicine, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Sabine Bohnet
- Department of Pulmonology, University Medical Center Schleswig Holstein Campus Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), German Center for Lung Research, Giessen, Germany
| | - Martin Reck
- Department of Thoracic Oncology, LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), German Center for Lung Research, Giessen, Germany
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Vitzthum K, Batra A, Pankow W, Raspe M, Rupp A, Andreas S. [Tobacco Cessation - The Underused Potential in Clinical Routine]. Pneumologie 2022; 76:126-138. [PMID: 35176793 DOI: 10.1055/a-1524-4478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Tobacco control, psychosocial and medical assistance regarding tobacco cessation is still a hidden potential within the German health care system. So far doctors rarely talk to their patients about their smoking status and physical and psychological benefits of quitting.This paper focusses on recommended current diagnostic and treatment standards, as well as evidence-based methods to address the topic on how to stop smoking and its association with certain diseases such as COPD, lung cancer and COVID-19 infection. The role of e-cigarettes as a cessation tool and its health related risks are critically examined. Consequences and advice how to implement smoking cessation procedures into daily practice are presented.
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