Lung cancer screening in a public health system in Brazil: integration of primary and tertiary care for respiratory care equity in Botucatu City

<bold>INTRODUCTION:</bold> Thoracic Low dose computed tomography (LDCT) screening has been shown to reduce lung cancer mortality risk. The implementation of lung cancer screening in the public health system is dependent on multidisciplinary groups, technology, and population access. <bold>OBJECTIVES:</bold> To offer access to lung cancer screening to individuals attending a smoking cessation program in public hospital. To determine the prevalence of pulmonary nodules identified in the target population and the rate of false negative for malignancies. <bold>METHODS:</bold> A multidisciplinary group outreached individuals in urban and rural areas and offered access to LDCT screening and smoking cessation interventions. Those meeting the lung cancer screening criteria (aged 45-75, smoking history of 30 PY or former smoker <15 years cessation) underwent thoracic LDCT scans. <bold>RESULTS:</bold> Between Feb/22 and Nov/23, 550 individuals were enrolled in the smoking cessation program and 310 met the criteria for screening. The majority were women (57%), mean age of 63±6 years, 29% black or of mixed race, 56% had low incomes and 58% had not completed elementary education. The individuals began smoking at 14±4 years, with an average of 62±33 PY. Among the enrolled individuals, 222 were active smokers and 21% used hand-made smoked cigarettes. Thoracic LDCT scans were performed on 277 patients, seven underwent biopsy, yielding one benign, one infectious, and five lung cancer cases. <bold>DISCUSSION:</bold> The findings emphasize that lung cancer screening can be effectively implemented in urban and rural areas, provided it is integrated into comprehensive public health systems, reinforcing prevention efforts.