PolmoniAMO_INGL

23 PolmoniAMO decile results in a two- to three-fold increase in the risk of false positives and of receiving excessive invasive treatment [53-56]. LDCT can also be used to calculate the degree of calcification of the coronary arteries, which is directly proportional to the risk of coronary artery infarction or stenosis. Lung cancer screening could therefore also offer a cardiovascular risk assessment. Moreover, with LDCT the presence or absence of emphysema patterns can be detected, thus antici- pating, for example, the diagnosis of COPD and its treatment, thereby reducing the asso- ciated chronic disability [57]. Overall, the option to undergo LDCT screening could be offered as part of a proactive approach to one’s personal health. A cultural shift is required, not only in terms of public opinion but also with regard to the opinion of those working in the sector who have historically been more cautious about the implementation of lung cancer screening, such as, for example, the Departments of Prevention, which, as territorial units, need to be proactive, especially when it comes to targeting the at-risk segment of the population which has appeared more responsive to direct calls (and/or letters of invitation) to the SSN cancer screening programmes. Finally, knowledge of the benefits that LDCT may offer in the treatment of a variety of smoking-re- lated diseases may increase awareness among local health authorities of the cost-effec- tiveness of the increased use of LDCT and state-of-the-art technologies. With this in mind, it is important that the public is made aware of the lower amount of radiation associat- ed with LDTC and that this information is highlighted, particularly given that the general public often has an alarmist and oppositional attitude when an examination involving radiation exposure is prescribed. Since the prospects for screening in Italy are correlated with the willingness of policy makers to implement interventions on a national scale [24], it is crucial to promote initiatives that effectively communicate the benefits of screening for the patient, for the treating physicians, for healthcare institutions and for society as a whole. b) Constructing a collaborative model for early diagnosis The issue of lung cancer screening cannot be the sole domain of oncologists. The screening conversation needs to be extended to other medical specialisations , since the majority of individuals who present the highest risk of developing lung cancer (e.g. smokers, COPD patients) are often seen by other medical specialists who then refer these patients to GPs for subsequent follow-ups. This would entail implementing refresh- er and educational initiatives aimed at multiple specialities, particularly in view of the fact that the occasional discovery of one or more pulmonary nodules on chest CT scans is not uncommon in asymptomatic patients. Predictive analyses indicated that out of 10,000 CT scans performed, around 1,000 to 1,200 revealed pulmonary nodules of which around 10% were considered worthy of follow-up, representing a further opportunity for early di- agnosis. Improving this awareness, however, will require initiatives to create rapid referral systems within the hospital by streamlining internal communications between specialists.