OBJECTIVES

: More than 50% of the world’s lung cancer cases occur in Asia and more than 20% of cancer deaths in Asia are attributable to lung cancer. Lung cancer screening has been shown to reduce lung cancer deaths. Using the Lung Cancer Policy Model–Asia (LCPM-Asia), we estimated the potential mortality reduction achievable through implementing computed tomography-based lung cancer screening in China, Japan, Singapore, and South Korea.

METHODS

: The LCPM-Asia was calibrated to the smoking prevalence of each of the aforementioned countries based on published national surveys and lung cancer mortality rates from the World Health Organization. The calibrated LCPM-Asia was then used to simulate lung cancer deaths under screening and no-screening scenarios for the four countries. Using screening eligibility criteria recommended by the U.S. Centers for Medicare & Medicaid Services (CMS), which are based on participants’ ages and smoking histories, we estimated the cumulative lung cancer mortality reduction from screening through year 2050.

RESULTS

: By 2050, lung cancer screening would result in 4.82% mortality reduction, preventing 721,589 lung cancer deaths in China; 5.75% mortality reduction and 68,194 lung cancer deaths prevented in Japan; 3.98% mortality reduction and 2,096 lung cancer death prevented in Singapore; 5.48% mortality reduction and 21,856 lung cancer death prevented in South Korea. As for mortality reduction by smoker type, current smokers would have the greatest mortality reduction in each country, from 7.04% in China to 8.02% in South Korea.

CONCLUSIONS

: Among the four countries, lung cancer screening based on CMS criteria was most effective in Japan and least effective in Singapore. Compared to the other countries, Singapore has the lowest smoking prevalence and Japan has the largest aging population, partially explaining the discrepancy in effectiveness. Therefore, to perform lung cancer screening effectively in each country, the eligibility criteria should be tailored to the country’s demographic characteristics.