The Stockholm Pilot study for Lung cancer Screening (Stockholm PLUS): feasibility of baseline low-dose CT lung cancer screening in a high-risk Swedish female population

Authors

  • Oscar Grundberg Thoracic Oncology Center, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden https://orcid.org/0000-0001-9405-9844
  • Paulina Kalinowska Department of Radiology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden https://orcid.org/0000-0002-5285-2200
  • Pierre Hillegren Department of Nuclear Medicine and Medical Physics, Karolinska University Hospital, Stockholm, Sweden https://orcid.org/0009-0009-1821-6217
  • Nicolas Peyrard Janvid Department of Radiology, Karolinska University Hospital, Stockholm, Sweden https://orcid.org/0009-0008-8839-4919
  • Axel Dimberg Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden https://orcid.org/0000-0002-6748-5140
  • Nina Markholm Nordgren Regional Cancer Centers in Sweden, Stockholm, Sweden
  • Fredrik Strand Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital, Stockholm, Sweden https://orcid.org/0000-0003-3910-7086
  • Vitali Grozman Department of Radiology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden https://orcid.org/0009-0002-4630-2832
  • Gunnar Wagenius Thoracic Oncology Center, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden

DOI:

https://doi.org/10.2340/1651-226X.2026.44826

Keywords:

Lung Neoplasm, Mass Screening, Low-Dose Computed Tomography, Early Detection of Cancer, Smoking, Artificial Intelligence

Abstract

Background and purpose: Low-dose CT screening of high-risk groups has been shown to reduce lung cancer mortality, and the European Council has therefore recommended that member states explore the feasibility and effectiveness of this approach. In this study, we evaluate the implementation of low-dose CT screening for lung cancer in a Swedish female population.

Patient/material and methods: Women aged 54–74 years in the Southern Stockholm region were contacted via an electronic questionnaire. Individuals who met the same eligibility criteria as in the NELSON trial (a minimum smoking history of 15 pack-years) were invited. The screening consisted of a baseline low-dose computed tomography (LDCT) scan, with the option for a follow-up scan in cases with intermediate findings. Findings were managed in accordance with modified Fleischner Society guidelines.

Results: Between September 2022 and September 2024, 34,580 invitation letters were sent to randomly selected women aged 54–74 years 11,607 individuals (33.4%) completed the questionnaire, whereof 1,106 (10%) met the inclusion criteria. 990 (90%) individuals accepted the invitation and underwent a baseline low-dose CT scan. There were 152 intermediate and 55 positive scans at baseline, and additional eight positive scans at follow-up. Fifteen cases of Lung cancer were found, yielding a positive prediction value (PPV) of 24%. 87% of the lung cancers were in stage IA.

Interpretation: Organized lung cancer screening in a Swedish female population proved feasible, demonstrating a good participation rate, and a cancer detection rate consistent with findings from other major screening trials.

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Published

2026-02-24

How to Cite

Grundberg, O., Kalinowska, P., Hillegren, P., Peyrard Janvid, N., Dimberg, A., Markholm Nordgren, N., … Wagenius, G. (2026). The Stockholm Pilot study for Lung cancer Screening (Stockholm PLUS): feasibility of baseline low-dose CT lung cancer screening in a high-risk Swedish female population . Acta Oncologica, 65, 164–172. https://doi.org/10.2340/1651-226X.2026.44826

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