Lung screening in Canada, 2023-24
Radiology
Most jurisdictions use the Lung-RADS Lung Nodule Management Protocol for lung screening reporting and management and offer specialized training for radiologists who will be reading LDCT scans for lung screening. One province is using the PanCan Lung Nodule Management Protocol for lung screening reporting and management.
Radiologist training
| P/T | Lung Nodule Management Protocol (e.g. Lung-RADS, PanCan) | Specialized training available? | Description of radiologist training |
|---|---|---|---|
| YT | – | – | – |
| NT | – | – | – |
| NU | – | – | – |
| BC | PanCan Lung Nodule Management Protocol and volumetric measurements | Yes | Prior to reading screening LDCTs, the radiologist must interpret at least 300 chest CT exams over the previous 36 months or have completed a Thoracic Imaging Fellowship. They must complete three Learning modules, CAD training, test cases using CAD, and structured report prior to reading screening cases. After the first year, the radiologist must read at least 500 LDCT exams a year, participate in multidisciplinary reviews, participate in provincial educational forum meeting that include diagnostic group, technologists, physicists to ensure team approach, and adhere to the Maintenance of Certification (MOC) program of the Royal College of Physicians and Surgeons of Canada. |
| AB | Lung-RADS® (2022) | No | No formal training required. Chest specialty radiologists, most with prior screening experience. Participation in monthly case reviews. |
| SK | Lung-RADS® | Under development | |
| MB | |||
| ON | Lung-RADS® | Yes; Ontario Lung Screening Program (OLSP) Radiologist Continuing Professional Development (CPD) Workshop offered by Ontario Health or the ‘Lung Cancer Screening – From Science to Practice’ course by the American College of Radiology (ACR) | Radiologists must complete required training prior to reading for the OLSP. Radiologists who are new to the OLSP must have their first 15 positive LDCT lung cancer screening interpretations (Lung-RADS® 3 or 4) double-read by a peer-matched site radiologist.
Radiologists participating in the OLSP must interpret at least 300 chest CT exams over the previous 36 months and 100 chest CT exams over the previous 12 months and complete CPD programs relevant to their practice, as per The Royal College of Physicians and Surgeons of Canada requirements for maintenance of certification. CPDs specific to lung cancer screening are recommended. Radiologists must participate in double-reads (all Lung-RADS® 4As are double read). |
| QC | Lung-RADS® | American College of Radiology (ACR) | Radiologists who have not completed a fellowship in thoracic imaging must complete additional training from a recognized body, currently the American College of Radiology, specifically in LDCT screening |
| NB* | – | – | – |
| NS | Lung-RADS® with modifications to enable a separate Lung-RADS 2 Ground Glass category to help determine transition from annual screening to biennial screening | Yes; in addition to QUEST, there will be education on Nova Scotia’s specific pathways, including the reporting and management of incidental findings, as well as monthly province-wide case reviews for radiologists | Will follow CAR accreditation standards for ongoing training; in particular, monthly case rounds in addition to peer review of positive cases with feedback provided |
| PE | Lung-RADS® (Proposed) | Yes, via CAR (proposed) | |
| NL | Lung-RADS® | Yes (ACR^ training) | Annual continuing medical education (CME) through program |
*NB: To be determined in consultation with Provincial Lung Cancer Screening Implementation Advisory Committee
^NL: American College of Radiology