ULS Gaia/Espinho in sustainable lung cancer screening project

A Local Health Unit Gaia/Espinho (ULSGE), whose lung cancer screening program has prevented 12 deaths in the past year, is now preparing to “test” a new model that can ensure more access and reduce costs.

The project is called TIME4LUNG, led by the Portuguese ‘startup’ iLoF (Intelligent Lab on Fiber), and in addition to ULSGE, other entities such as the University of Aveiro and the Clinical Academic Center Egas Moniz Health Alliance (EMHA) participate.

“It is very difficult [the current model] to be sustainable and achieve an equitable implementation in the Portuguese territory, as there are not enough technological and human resources to be able to expand the entire eligible population,” Lusa told the director of the Unit of Planning, Innovation and Health Management of the ULSGE Populations.

Highlighting that the main objective of TIME4LUNG is to “democratize access to the screening program”, Firmino Machado explained that “the project aims to demonstrate that it is possible to implement a two-step lung cancer screening program, minimizing complexity and slowness for the patient and, at the same time, reducing costs for institutions”.

In 2022, the European Commission recommended to its Member States that they initiate pilot lung cancer screening projects associated with smoking cessation programmes. In Portugal, the theme has been on the table for several legislatures, currently discussing the methodology to be adopted.

So far, it has been considered that the most effective test to detect lung cancer at an early stage is a low-dose chest computed tomography (TAC) (normal CAD with less radiation dose).

Subsequently, there is a need for articulation with the National Health Service to access the treatment of all the findings in the examination.

Ulsge started a lung cancer screening program that was naturally confined to the eligible population of the municipalities of Vila Nova de Gaia and Espinho in September last year.

Data collected until September 29 of this year indicate that 1,138 users were considered eligible. Of these, 1,083 were effectively tracked. The rest will not have attended the call.

“ We identified 12 people without any symptoms and who had lung cancer. They would probably end up dying of lung cancer, because they would already be diagnosed at a very advanced stage, without any therapeutic capacity ", advanced to Lusa Firmino Machado, anticipating why ULS Gaia Espinho decided to join the consortium that now intends to test a new model for screening.

“ We came across a responsibility as a pioneering center for implementing the screening program (...)”, he said.

With TIME4LUNG, a two-step tracking model will be tested. The first will consist of taking some blood and doing a technique called optomic. The second stage is CT, but this will only be done if the optics refers to a positive result, i.e. detecting a risk of lung cancer.

“ This means that we would only do the screening of classical lung cancer with low-dose TAC, that is, only exposure to radiation, users who tested positive in the initial blood assessment”, he said.

In the technical description of the project, it is read that “with the use of optomics technology and artificial intelligence, a biological signature will be sought to help predict the probability of a person presenting a positive result on a computed tomography screening”.

There are advantages to reduce the costs of implementing the screening program, greater financial sustainability, greater diffusion in the national territory and lower exposure of all screened to the radiation of TACs.

With the duration of three years, this project is still in the recruitment phase of the team, creating the machine that will analyze the blood and requires that there are users who are available to donate a tube of blood for this investigation.

“ If everything goes as planned, it is expected that after three years this innovation can be transferred to clinical practice ", said Firmino Machado.

The project has an overall investment of €8.7 million, with a financial incentive of €6.66 million, allocated under Portugal 2030/Compete 2030.

The joint participation of UlsGE and the University of Aveiro represents funding of EUR 1.8 million.