Foreword

Clinical practice guidelines for the diagnosis of lung cancer (screening draft guidelines)

Foreword

This work consolidates the internationally unique, wiki-based revision of the 2004 first Australian evidence-based “Clinical guidelines for the prevention, diagnosis and management of lung cancer” paperback format with endorsement by the National Health and Medical Research Council.

The work, initially commissioned by Cancer Australia (CA), was undertaken by the CCA to develop a sustainable web-based wiki platform with revised guidelines for the treatment of lung cancer with the first phase being restricted to the treatment of non-small cell and small cell lung cancer (chapters 5 and 6 respectively of the 2004 version) and supporting the patient and palliative care (chapters 4, 7 and 8), now publicly available and widely used at Clinical practice guidelines for the treatment of lung cancer.

The success of the treatment recommendations in guiding clinical practice in Australia has now enabled CCA to move to the second phase, addressing topics of prevention, screening, diagnosis and assessment. To kick off this next phase, we present 3 draft guidelines pertaining to the screening of lung cancer, timely given the increasing interest in low dose CT (LDCT) screening around the world based on the pivotal NLST trial.

Specifically, the multidisciplinary working group, including consumers and New Zealand participation, has carefully examined the evidence for 3 focused questions:

• In people at risk of lung cancer, does population based screening with chest radiography reduce mortality?

• In people at risk of lung cancer, does population based CT screening reduce mortality?

• Which population group would potentially most benefit from CT screening for lung cancer?

As with other wiki guidelines, despite an extensive and rigorous review progress, these online resources will not be final, and as intended represent a living and evolving document, suitable for interactive comment and debate, in addition to the guideline writing tradition of modification to learn from emerging evidence. We have targeted this guidance for practice in Australia, and expect that the evidence base and therefore their clinical implications may be similarly applied in New Zealand.

Consequently, we invite readers and stakeholders, who become aware of new evidence to create a personal account on the wiki and contribute comment online, so that their views are duly considered by the public and to enable the working party to consider any subsequent changes or refinement to the recommendations.

Further work on this second phase of the Australian diagnostic and evaluation lung cancer wiki guidelines will continue, with the areas of prevention, diagnosis and assessment to be considered next.

We sincerely hope the wiki will be an accessible up-to-date resource for multi-disciplinary teams, individual clinicians, students and consumers, and look forward to your feedback and discourse.

I thank the CCA for intense backroom work that underpins these guidelines, this output is only achieved by an enormous amount of support from the project team at CCA; Jutta von Dincklage, Laura Wuellner, Emma Dickins, Christine Vuletich and Clara Ha, working closely with members of the working party who have given up weekends and evenings to contribute their expertise to help address the heavy burden of lung cancer in Australia.

Professor Kwun Fong

Chair, Cancer Council Australia Lung Cancer Prevention and Diagnosis Guidelines Working Party