| YT |
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| NT |
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| NU |
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| BC |
- The Lung Screening Program was launched in April 2022 and all 36 screening sites across the province are currently operational
- Screening intake and eligibility assessment, smoking cessation counselling, and referral for screening low-dose CT (LDCT) scan are done by trained and centralized navigators in the program
- The screening program information system (CASCADE) generates CT referral to local screening sites where the local CT department contacts clients to book scans
- CASCADE receives and generates results letters
- Follow-up protocols are built into CASCADE, including return to screening referrals and fast-track diagnostic workup referrals
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| AB |
The Alberta Lung Cancer Screening Program (ALCSP) is a pilot project funded through Alberta Health Services (AHS) and the Canadian Partnership Against Cancer (CPAC). The program is expected to implement LDCT Scans for approximately 3,000 people (1,500 annually) aged 50–74, who currently smoke commercial tobacco or previously smoked cigarettes.
PCPs will refer patients to the ALCSP for LDCT and to enhanced tobacco cessation program (if appropriate) based on lung cancer risk assessment (PLCOm2012 3-race model lung cancer risk ≥1.5% over six years). The initial pilot will be limited to geographic areas with high smoking rates and higher-risk populations, including Indigenous and immigrant populations. Evaluation will be ongoing throughout the project to plan for province-wide implementation.
Key milestones include:
- Established steering committee and five working groups
- Development of a project workplan, and other project documents: program policies/guidelines were developed, including eligibility criteria, risk assessment tool, Lung-RADS criteria for scoring results, screening pathway, and tobacco cessation integration
- Selection of and engagement with six Primary Care Networks (PCNs)
- Development of Communications and Engagement Plan
- Development of Indigenous Engagement Plan, including engagement with key Indigenous stakeholders
- Development of program education, resources, and website for patients and providers
- Development of Enhanced Tobacco Cessation Integration Plan
- Recruitment of project staff, including a nurse practitioner, clerk, and Tobacco Cessation Case Manager (the latter is funded by Cancer Prevention Screening and Innovation)
- Development of project correspondence (patient and provider results letters)
- Approval and completion of the design and build of the IMIT Strategy, Connect Care
- Submission of a Privacy Impact Assessment
- Development of an evaluation framework and evaluation plan, and identification of key performance measures
- Program QI/QA component established
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| SK |
- Creation of project governance and shared decision-making structures to support co-creation of the program with health system and community partners
- Hiring and onboarding of core program staff to progress program development
- Eight major components of development work have been established and are working through key decisions. These components include:
- Community engagement and outreach
- Quality measurement/improvement and monitoring
- Diagnosis/treatment pathways
- Smoking cessation
- Program eligibility
- Program navigation
- Diagnostic/lung nodule management
- IT systems
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| MB |
Manitoba is planning for provincial implementation of lung cancer screening. Key activities since 2021 include:
- Establishing an Expert Advisory Group, Public Advisory Group, and several working groups to build consensus, provide recommendations, and complete activities
- Confirming key aspects of the patient pathway, including:
- Acceptance of self-referrals for those without a PCP
- Entry-age criteria (55–74 years)
- Screen eligibility criteria (PLCOm2012 no race at a threshold of 1.5%), determined by LungCheck
- Process for central intake and referral to CT
- PanCan nodule management protocol
- Direct referral to Lung Diagnostic Clinic
- Navigation for full pathway
- Confirming that smoking cessation support, including paid medications and aids, will be provided through the program
- Developing education and awareness resources for the public, PCPs, and specialists. Public resources and materials were developed through public and community engagement
- Determining requirements for client registry and CT reporting software (procurement underway)
- Determining radiologist reading and training requirements, and accreditation requirements
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| ON |
- In April 2021, the Lung Cancer Screening Pilot for People at High Risk (the pilot) transitioned from a pilot to a program and the four sites that participated in the pilot have continued to offer organized lung cancer screening through the Ontario Lung Screening Program (OLSP). The final evaluation of the pilot was completed and results are currently being prepared for publication.
- Ontario Health is planning for expansion of the OLSP, which includes onboarding new screening sites across the province and implementing program enhancements identified during the pilot phase. The majority of remaining hub sites (designated Thoracic Cancer Surgery Centres) will be added from 2024 to 2026.
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| QC |
- Screening is available in ten facilities, with three more being added throughout 2024.
- An evaluation of the demonstration project was completed in Spring 2024.
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| NB |
- The primary goal of the CPAC-funded project was to gather data and complete the NB Lung Cancer Screening Implementation Plan (2021–2022)
- Participated in the development of CPAC’s Standardized Lung Cancer Screening Business Case (2021)
- NBCN received and secured funding to implement a Provincial Lung Cancer Screening Program (2023)
- Implementation activities have begun:
- Formed the Provincial Lung Cancer Screening Advisory Committee
- Began process of building IT infrastructure (2023)
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| NS |
Through the generous support of funding from CPAC, Nova Scotia:
- Created a project charter and project plan
- Submitted a business case for sustained funding
- Developed a comprehensive communications plan
- Worked on communications materials for PCPs, patients, and scripts for staff working directly with patients
- Hired two nurse navigators and one booking clerk, with additional recruitment taking place in summer 2023
- Established partnerships with the Centre for Addiction and Mental Health (CAMH) for distribution of Nicotine Replacement Therapy (NRT) and with Tobacco Free Nova Scotia for smoking cessation behavioural counselling
- Developed processes specific to diagnostic imaging
- Modified the IT system (CCASPER) application for management of cancer screening programs to include the lung program
- Conducted a robust engagement process facilitated by an external consultant
- Developed strategies for unattached patients to ensure Nova Scotians without a PCP would still be able to participate fully in the program
- Drafted a privacy impact assessment
- Developed an evaluations strategy, including identification of key performance indicators
- Established an environmental-risk-factors working group
- Developed quality assurance metrics and processes for radiology
- Drafted a Phase 2 Project Plan with CPAC
- Developed a Zone/Site/Community Readiness Assessment Tool
- Confirmed Nova Scotia-specific guidelines for eligibility of LDCT screening
- Developed program pathways for end-to-end patient navigation
- Developed terminology for screening reporting templates
- Developed machine-readable versions of standardized radiology reports
- Created a phased implementation plan
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| PE |
- Creation and approval of Provincial Cancer Strategy 2023–2028, including lung cancer screening.
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| NL |
- Thoracic Triage Panel supported by cancer screening program
- Business case for provincial lung screening submitted to government
- Work to support lung cancer screening done in Health Connect IT System
- Work underway to support operationalizing two-site pilot lung screening program
- Provincial advisory committee established with four working groups
- Numerous meetings held with Ministry of Health
- Recruitment of cancer screening nurse practitioner that will assist in delivery of Lung Screening Program
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