PolmoniAMO_INGL

10 programmes are no longer sustainable. If prevention is the key to longevity, action must be taken now to make the most effective tool for beating lung cancer - screening - accessible to those at risk. 1.1 The individual and societal impacts of lung cancer Lung cancer has long been overlooked, despite numerous epidemiological in- vestigations revealing its worrying and increasing morbidity and mortality in recent decades. AIRTUM (the Italian Association of Cancer Registries) estimates that there were 40,850 new lung cancer diagnoses in 2020 (27,550 in men and 13,300 in women), representing 14.1% of all cancer diagnoses in men and 7.3% in women [3]. Lung cancer accounts for the highest number of cancer deaths each year (an estimated 34,000 in 2021) . In 2021, the predicted mortality rate for lung cancer was 26.5/100,000 in male patients, a decrease of 15.6 % compared to 2015. Nonetheless, the number of deaths caused by this cancer (23,100) represents almost a quarter of all cancer deaths in men recorded in Italy. Conversely, the predicted mortality rate for lung cancer in women has dramatically increased by 5% since 2015, reaching 11.3/100,000 in 2021. No less worrying are the five-year survival figures for this disease, which stand at 16% for male patients and 23% for female patients. In individuals who have survived for more than one year after diagnosis, the probability of living another four years is 37% in men and 44% in women. These data also account for the reduced prevalence of lung cancer with only 117,800 people surviving compared to, for exam- ple, 513,500 people surviving after a diagnosis of colorectal cancer (43,700 new cases in 2020) [3]. In Italy, lung cancer has an economic cost of approximately €2.5 billion, taking into account both direct healthcare costs and indirect and/or social ones [4]. The biggest contributor to costs is hospital treatment, whether in terms of surgery or radio- and chemotherapy. This is not surprising in view of the data from the latest National Outcomes Programme report. In fact, an increase in surgeries for malignant lung cancer was observed in the five-year period 2015-2020, with 12,116 surgical pro- cedures in 2019 [5]. The average costs per hospitalisation for a patient with lung cancer have been estimated to exceed €9,300 [6,7]. Assuming that the 117,800 people surviving for one year after being diagnosed with lung cancer received hospital treatment, the cost to the healthcare system can be estimated at well over €1 billion. In addition to healthcare costs there are social costs, the amount of which is significant given that indirect costs related to lost working hours for patients and/or their caregivers, or the need to take early retirement can greatly exceed the direct costs reported in clinical studies [8]. In the analysis of the impact of lung cancer, social security costs were also assessed, i.e. the costs related to social security benefits