Lung cancer screening in Canada: 2021/2022

How to use this report

This environmental scan summarizes the data collected from provincial and territorial lung screening programs and is intended to inform provincial/territorial decision-making for policy and practice. The information for this environmental scan was collected in summer 2021 and all provinces and territories responded.

Impact of COVID-19 on screening services

The COVID-19 pandemic has had a profound impact on health services across the country, causing many jurisdictions to pause screening in 2020. Notwithstanding, screening programs were able to adapt and develop new innovative strategies to address the challenges of the COVID-19 pandemic. The data collected in this environmental scan reflects standard guidelines in each jurisdiction.

The COVID-19 pandemic widened pre-existing disparities and disproportionately impacted certain populations, including First Nations, Inuit, and Métis populations. It is anticipated that these communities will continue to be disproportionately impacted in the future, and more than ever it is imperative to tailor strategies to reach underscreened populations to ensure that these disparities are not further widened.

Alignment with the Canadian Strategy for Cancer Control, 2019-2029

The Canadian Strategy for Cancer Control calls for the continued focus on existing screening programs, such as continuing measures to ensure the right people are getting screened at the right times, and eliminating barriers to participation in screening, particularly in underscreened communities. The Strategy also calls for the adoption of innovations and enablers that allow cancer care to be provided closer to home and in a culturally sensitive manner.

This environmental scan reflects Priority 2, Action 2, and Priority 4, Actions 1 and 2, of the Strategy.

priority 2

Priority 2: Diagnose cancer faster, accurately and at an earlier stage
Action 2: Strengthen existing screening efforts and implement lung cancer screening programs across the country

priority 4

Priority 4: Eliminate barriers to people getting the care they need
Action 1: Provide better services and care adapted to the specific needs of underserved groups
Action 2: Ensure rural and remote communities have the resources required to better serve their people

Lung cancer screening pathway

Cancer screening pathways are a general representation of the organized screening process, and may not apply to all jurisdictions, especially those which do not have an organized screening program.

Primary care providers are an important piece of the lung screening pathway and are involved at multiple steps, including providing an initial referral, follow-up of incidental findings, smoking cessation support (including pharmacotherapy) and supporting with interpreting screening results.
Step 1: Healthcare provider referral, self-referral, program invitation or recall for the eligible population at high-risk. Step 2: Risk Assessment. Step 3 for Eligible and Non eligible: Smoking cessation counselling and/or pharmacotherapy (if required). Or Step 3 for Eligible people can be a Screening test (low dose computed tomography). Step 4: Communication of results to participant and physician. Step 5 for normal results is Recalled back for screening according to program guidelines. Step 5 for abnormal results is Early recall LDCT or diagnostic follow-up (imaging or invasive procedure). If there is no cancer, then Step 6 is Recalled back for screening according to program guidelines. If there is an abnormal result, then Step 6 is Refer for appropriate follow-up testing or treatment.

Data notes:  

  • Data displayed in the environmental scan is taken from provincial and territorial lung cancer screening programs. Data may be edited for grammar and formatting.