IMPLEMENTATION READINESS FOR LOW-DOSE COMPUTED TOMOGRAPHY LUNG CANCER SCREENING IN JAPAN, MALAYSIA, AND THAILAND: A SCOPING REVIEW
Author(s)
Anand Jha, MBA1, Monica Verma, MPH2, Sanowar Sayeed, M.Pharm3.
1Ansea Consultants Pte Ltd, Singapore, Singapore, 2Associate Director, Ansea Consultants Pte Ltd, Singapore, Singapore, 3Ansea Consultants Pte Ltd, Delhi, India.
1Ansea Consultants Pte Ltd, Singapore, Singapore, 2Associate Director, Ansea Consultants Pte Ltd, Singapore, Singapore, 3Ansea Consultants Pte Ltd, Delhi, India.
OBJECTIVES: To map evidence, policy status, and implementation barriers for low-dose computed tomography (LDCT) lung cancer screening in Japan, Malaysia, and Thailand, and identify policy and HTA priorities for equitable access. These countries were purposefully selected to reflect diverse socio-economic and health-system contexts.
METHODS: We conducted a scoping review of PubMed and Web of Science (searched 6 Aug 2025), supplemented by snowballing approach. Eligible sources included empirical studies, economic evaluations, guidelines, HTA reports, and national cancer-control documents relevant to LDCT screening. Data were charted on policy positioning, eligibility and risk stratification, access readiness, risk prediction, and local diagnostic modifiers, including tuberculosis (TB) and nodule-management protocols.
RESULTS: LDCT screening readiness and policy translation varied across the three countries. Japan had the strongest LDCT evidence base and established quality and training structures, but LDCT is delivered mainly opportunistically rather than through a nationwide program. Malaysia and Thailand lack national LDCT screening programs, with evidence limited to private-sector availability, research settings, or small-scale pilots. Across settings, eligibility remains uncertain, particularly where never-smokers constitute a substantial share of cases. Existing risk prediction models for never-smokers include age, gender, body mass index, and family history of lung cancer, but limited performance and uncertain generalizability may restrict policy use. Implementation barriers clustered around access and delivery: Malaysia emphasized limited availability and participation barriers, including affordability, while Thailand highlighted geographic access constraints and capacity limitations. In TB-endemic settings, nodule interpretation and false-positive management emerged as key adaptation needs.
CONCLUSIONS: Readiness differs markedly across Japan, Malaysia, and Thailand. Near-term national scale-up is premature in Malaysia and Thailand; phased pilots linked to evidence generation could reduce uncertainty while supporting equitable implementation. Priorities include locally validated risk stratification and risk prediction models, TB-adapted nodule-management pathways, and local effectiveness and economic evidence to inform guidelines and HTA decisions.
METHODS: We conducted a scoping review of PubMed and Web of Science (searched 6 Aug 2025), supplemented by snowballing approach. Eligible sources included empirical studies, economic evaluations, guidelines, HTA reports, and national cancer-control documents relevant to LDCT screening. Data were charted on policy positioning, eligibility and risk stratification, access readiness, risk prediction, and local diagnostic modifiers, including tuberculosis (TB) and nodule-management protocols.
RESULTS: LDCT screening readiness and policy translation varied across the three countries. Japan had the strongest LDCT evidence base and established quality and training structures, but LDCT is delivered mainly opportunistically rather than through a nationwide program. Malaysia and Thailand lack national LDCT screening programs, with evidence limited to private-sector availability, research settings, or small-scale pilots. Across settings, eligibility remains uncertain, particularly where never-smokers constitute a substantial share of cases. Existing risk prediction models for never-smokers include age, gender, body mass index, and family history of lung cancer, but limited performance and uncertain generalizability may restrict policy use. Implementation barriers clustered around access and delivery: Malaysia emphasized limited availability and participation barriers, including affordability, while Thailand highlighted geographic access constraints and capacity limitations. In TB-endemic settings, nodule interpretation and false-positive management emerged as key adaptation needs.
CONCLUSIONS: Readiness differs markedly across Japan, Malaysia, and Thailand. Near-term national scale-up is premature in Malaysia and Thailand; phased pilots linked to evidence generation could reduce uncertainty while supporting equitable implementation. Priorities include locally validated risk stratification and risk prediction models, TB-adapted nodule-management pathways, and local effectiveness and economic evidence to inform guidelines and HTA decisions.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HSD18
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology