Liquid biopsy ; Low-dose computed tomography ; Lung cancer screening ; Multi-cancer early detection ; National Lung Cancer Screening Program
Abstract
This review examines the current status and recent progress in lung cancer screening programs, focusing on low-dose computed tomography (LDCT) and emerging liquid biopsy technologies. In Korea, the National Lung Cancer Screening Program has shown promising results in reducing lung cancer mortality since its implementation in 2019. This review discusses the LDCT screening in Korea, including reductions in short-term mortality, increased screening uptake, and enhanced smoking cessation rates. Results from major international trials, including the National Lung Screening Trial, Nederlands-Leuvens Longkanker Screenings Onderzoek trial, and Multicenter Italian Lung Detection studies, demonstrating the efficacy of LDCT in reducing lung cancer mortality, are reviewed. The potential of liquid biopsy as a complement to LDCT is explored, with a focus on multi-cancer early detection technologies. Notable advances include the Circulating Cell-free Genome Atlas study and the Galleri® test, which have shown promise in detecting cancer at early stages through blood-based screening. We also highlight the challenges and limitations of current screening methods, including the need to improve strategies for screening non-smokers and the importance of balancing benefits against risks. As lung cancer screening continues to advance, combining LDCT and liquid biopsy is anticipated to provide more comprehensive and effective early detection strategies.