4-IN THE LUNG RUN: towards INdividually tailored INvitations, screening INtervals, and INtegrated co-morbidity reducing strategies in lung cancer screening

Project Information

4-IN THE LUNG RUN

Grant agreement ID: 848294

DOI

10.3030/848294

EC signature date 6 December 2019

Start date 1 January 2020

End date 31 December 2025

Funded under

• SOCIETAL CHALLENGES - Health, demographic change and well-being

Total cost

€ 7 999 948,75

EU contribution

€ 7 999 948,75

Coordinated by

ERASMUS UNIVERSITAIR MEDISCH CENTRUM ROTTERDAM
Netherlands

CORDIS provides links to public deliverables and publications of HORIZON projects.

Links to deliverables and publications from FP7 projects, as well as links to some specific result types such as dataset and software, are dynamically retrieved from OpenAIRE .

Deliverables

Documents, reports (15)

recruitment: description target population/ area

Description of dominant MPSG in high risk areas (that tend to elect not to participate but which are at high risk), and of MPSG for optimisation in those who tend to participate (M6)

Biomarkers: Validation circulating miRNA

Validation of two different computational models of circulating miRNAs to maximize sensitivity for risk prediction and specificity for differential diagnosis

Project Management: informed consent form

- The informed consent procedures that will be implemented for the participation of humans will be explained into detail. - providing templates of the informed consent form (per country)

Biomarkers: composite risk predicting panel

Combination of miRNAs, inflammatory proteins and cardio-pulmonary damage in a composite risk predicting panel.

recruitment: development tailored recruitment

Identification of the preferred per country and most effective channels of communication and development of the tailored intervention, with different MPSG profiles, at high risk of developing lung cancer, including qualitative data on the participants’ view of the methods

Smoking cessation: report on biofeedback CT

Report about which information about lung cancer risk and risk for developing co-morbidities (e.g. Coronary Artery Disease reflected by the coronary artery calcification (Agatston score), COPD) derived from the CT scan could be useful in motivating smokers to quit smoking

Health communication: evaluation (non-)participants

Report on informed choice (non)-participants

recruitment: evaluation tailored recruitment

Report that describes and compares the effects and efficacy of the general and tailored recruitment approaches

Protocol: study protocol 4-IN-THE-LUNG-RUN

Design of the study protocol

Data protection: security

A description of the security measures that will be implemented to prevent unauthorised access to personal data or the equipment used for processing

Smoking cessation: development smoking cessation intervention

Report on barriers and facilitators for participating in lung cancer screening, receiving personal health information and smoking cessation.

Protocol: Nodule Management Strategy

design of the lung cancer nodule management protocol

recruitment: testing tailored recruitment

Implemented testing of each type of tailored intervention in relevant areas of partner 3 iDNA, using quantitative and qualitative (interview) responses from participants to refine the intervention as we do so, in an iterative approach, until we have established that the proposed interventions are acceptable and feasible to the target groups, and establish differences in recruitment rate after 12 months of recruitment

Approval: study protocol - registration

i Final version of study protocol as submitted to regulatorsethics committees ii Registration number of clinical study in a WHOor ICMJE approved registry with the possibility to post resultsiii Approvals ethics committees and national competent authority if applicable required for invitationenrolment of first subject in at least one clinical centre

Data protection: privacy - anonymised/ pseudomysed data

explain why the research data will not be anonymised/ pseudonymised

Publications

Peer reviewed articles (21)

Personalising lung cancer screening: An overview of risk‐stratification opportunities and challenges

Author(s): Kevin Haaf, Carlijn M. Aalst, Harry J. Koning, Rudolf Kaaks, Martin C. Tammemägi
Published in: International Journal of Cancer, Issue 149/2, 2021, Page(s) 250-263, ISSN 0020-7136
Publisher: John Wiley & Sons Inc.
DOI: 10.1002/ijc.33578

Implementation of lung cancer screening: what are the main issues?

Author(s): Carlijn M. van der Aalst, Kevin ten Haaf, Harry J. de Koning
Published in: Translational Lung Cancer Research, Issue 10/2, 2021, Page(s) 1050-1063, ISSN 2218-6751
Publisher: AME Publishing Company
DOI: 10.21037/tlcr-20-985

Paradigm shift in early detection: Lung cancer screening to comprehensive CT screening

Author(s): James L. Mulshine, Bruce Pyenson, Cheryl Healton, Carolyn Aldige, Riccardo S. Avila, Torsten Blum, Matthew Cham, Harry J. de Koning, Sean B. Fain, John K. Field, Raja Flores, Maryellen L. Giger, Ilya Gipp, Frederic W. Grannis, Jan Willem C. Gratama, Ella A. Kazerooni, Karen Kelly, Harriet L. Lancaster, Luis Montuenga, Kyle J. Myers, Morteza Naghavi, Raymond Osarogiagbon, Ugo Pastorino, Anthony P.
Published in: European Journal of Cancer, Issue 218, 2025, Page(s) 115264, ISSN 0959-8049
Publisher: Pergamon Press Ltd.
DOI: 10.1016/j.ejca.2025.115264

Upfront blood microRNA test in LDCT-reluctant individuals: insights from the biomild trial

Author(s): Gabriella Sozzi, Federica Sabia, Luigi Rolli, Miriam Segale, Paola Suatoni, Anna Zanghi, Margherita Ruggirello, Alfonso Marchianò, Mattia Boeri, Ugo Pastorino
Published in: Journal of Experimental & Clinical Cancer Research, Issue 44, 2025, ISSN 1756-9966
Publisher: Springer Science and Business Media LLC
DOI: 10.1186/s13046-025-03424-5

Action plan for an international imaging framework for implementation of global low-dose CT screening for lung cancer

Author(s): Harriet L. Lancaster, Anna N.H. Walstra, Kyle Myers, Ricardo S. Avila, Jan Willem C. Gratama, Marjolein A. Heuvelmans, Sean B. Fain, David A. Clunie, Ella A. Kazerooni, Maryellen L. Giger, Anthony P. Reeves, Jens Vogel-Claussen, Harry de Koning, Rowena Yip, Luis M. Seijo, John K. Field, James L. Mulshine, Mario Silva, David F. Yankelevitz, Claudia I. Henschke, Matthijs Oudkerk
Published in: European Journal of Cancer, Issue 220, 2025, Page(s) 115323, ISSN 0959-8049
Publisher: Pergamon Press Ltd.
DOI: 10.1016/j.ejca.2025.115323

Annual Progression of Coronary Artery Calcium Agatston Score in The 4-IN-THE-LUNG-RUN Lung Cancer Screening Trial

Author(s): A. Walstra, S. Zhang, K. Togka, C. Van Der Aalst, H. De Koning, M. Oudkerk
Published in: Journal of Cardiovascular Computed Tomography, Issue 19, 2025, Page(s) S31, ISSN 1934-5925
Publisher: Elsevier BV
DOI: 10.1016/j.jcct.2024.12.081

Blood microRNA testing in participants with suspicious low-dose CT findings: follow-up of the BioMILD lung cancer screening trial

Author(s): Mattia Boeri, Federica Sabia, Roberta E. Ledda, Maurizio Balbi, Paola Suatoni, Miriam Segale, Anna Zanghì, Anna Cantarutti, Luigi Rolli, Camilla Valsecchi, Giovanni Corrao, Alfonso Marchianò, Ugo Pastorino, Gabriella Sozzi
Published in: The Lancet Regional Health - Europe, Issue 46, 2024, Page(s) 101070, ISSN 2666-7762
Publisher: Elsevier BV
DOI: 10.1016/j.lanepe.2024.101070

Influence of changing patterns in lung cancer treatment and survival on the cost-effectiveness of CT screening: a modeling study

Author(s): Koen de Nijs, Kevin ten Haaf, Dana Moldovanu, Juul Hubert, Isabelle van den Bosch, Anouk Eijkelboom, Carlijn van der Aalst, Harry J. de Koning
Published in: eClinicalMedicine, Issue 88, 2025, Page(s) 103446, ISSN 2589-5370
Publisher: Elsevier BV
DOI: 10.1016/j.eclinm.2025.103446

P1.15-03 Dedicated Cardiovascular Screening in Lung Cancer Screening: Preliminary Results from the European 4-IN-THE-LUNG-RUN Trial,

Author(s): M. Vonder, C. van der Aalst, J. Hubert, D. Moldovanu, A. Schmitz, J.W.C. Gratama, M. Silva, H. de Koning, M. Oudkerk
Published in: Journal of Thoracic Oncology, Issue Volume 18, Issue 11, Supplement, 2023, 2023, Page(s) Pages S218-S219, ISSN 1556-0864
Publisher: Lippincott Williams & Wilkins Ltd.
DOI: 10.1016/j.jtho.2023.09.355

Lung cancer screening implementation: turning evidence into practice

Author(s): Marjolein A Heuvelmans
Published in: The Lancet Oncology, Issue 26, 2025, Page(s) 535-537, ISSN 1470-2045
Publisher: The Lancet Publishing Group
DOI: 10.1016/s1470-2045(25)00138-x

Projected effectiveness of lung cancer screening and concurrent smoking cessation support in the Netherlands

Author(s): Koen de Nijs, Kevin ten Haaf, Carlijn van der Aalst, and Harry J. de Koning
Published in: eClinical Medicine, Issue 2024; 102570, 2024, Page(s) 102570, ISSN 2589-5370
Publisher: Elsevier BV
DOI: 10.1016/j.eclinm.2024.102570

Cardiovascular Screening In Lung Cancer Screening: The European Prospective Approach 4-in-the-lung-run

Author(s): M. Vonder, C. van der Aalst, D. Moldovanu, J. Hubert, A. Schmitz, J. Gratama, M. Silva, H. de Koning, M. Oudkerk
Published in: Journal of Cardiovascular Computed Tomography, Issue Volume 17, Issue 4, Supplement, 2023, Page(s) S46, ISSN 1934-5925
Publisher: Elsevier BV
DOI: 10.1016/j.jcct.2023.05.116

Feasibility of AI as First Reader in the 4-IN-THE-LUNG-RUN Lung Cancer Screening Trial: Impact on Negative-Misclassifications and Clinical Referral Rate

Author(s): Anna N H Walstra, Harriet L Lancaster, Marjolein A Heuvelmans, Carlijn M van der Aalst, Juul Hubert, Dana Moldovanu, Sytse F Oudkerk, Daiwei Han, Jan Willem C Gratama, Mario Silva, Harry J de Koning, Matthijs Oudkerk
Published in: European Journal of Cancer, 2024, Page(s) 115214, ISSN 0959-8049
Publisher: Pergamon Press Ltd.
DOI: 10.1016/j.ejca.2024.115214

Lung cancer screening and smoking cessation efforts

Author(s): Dana Moldovanu, Harry J. de Koning, Carlijn M. van der Aalst
Published in: Translational Lung Cancer Research, Issue 10/2, 2021, Page(s) 1099-1109, ISSN 2218-6751
Publisher: AME Publishing Company
DOI: 10.21037/tlcr-20-899

Screening for multiple cancers: evaluation must go beyond aggregate measures

Author(s): Thomas Callender, Katherine Payne, Nora Pashayan, Anne Mackie
Published in: BMJ, 2025, Page(s) e081098, ISSN 1756-1833
Publisher: BMJ
DOI: 10.1136/bmj-2024-081098

P1.14-04 European Lung Cancer Screening Implementation: 4-IN-THE-LUNG-RUN trial

Author(s): C. van der Aalst, M. Vonder, J. Hubert, D. Moldovanu, A. Schmitz, S. Delorme, R. Kaaks, K. ten Haaf , M. Oudkerk, H. de Koning
Published in: Journal of Thoracic Oncology, Issue Volume 18, Issue 11, Supplement, November 2023, 2023, Page(s) Page S217, ISSN 1556-1380
Publisher: Elsevier
DOI: 10.1016/j.jtho.2023.09.352

MA19.06 Artificial Intelligence as Concurrent Reader in Prospective European Lung Cancer Screening (4-IN-THE-LUNG-RUN) Trial

Author(s): M. Vonder, C. van der Aalst, J. Hubert, D. Moldovanu, A. Schmitz, S. Delorme, J.W. Gratama, M. Silva, H. de Koning, M. Oudkerk
Published in: Journal of Thoracic Oncology, Issue Volume 18, Issue 11, Supplement, November 2023, 2023, Page(s) Page S172, ISSN 1556-1380
Publisher: Elsevier
DOI: 10.1016/j.jtho.2023.09.256

Low‐dose computed tomography lung cancer screening: Clinical evidence and implementation research

Author(s): Harriet L. Lancaster, Marjolein A. Heuvelmans, Matthijs Oudkerk
Published in: Journal of Internal Medicine, Issue 292, 2023, Page(s) 68-80, ISSN 0954-6820
Publisher: Blackwell Publishing Inc.
DOI: 10.1111/joim.13480

Lung cancer volume doubling time by computed tomography: A systematic review and meta-analysis

Author(s): Beibei Jiang, Daiwei Han, Carlijn M. van der Aalst, Harriet L. Lancaster, Marleen Vonder, Jan-Willem C. Gratama, Mario Silva, John K. Field, Harry J. de Koning, Marjolein A. Heuvelmans, Matthijs Oudkerk
Published in: European Journal of Cancer, Issue 212, 2025, Page(s) 114339, ISSN 0959-8049
Publisher: Pergamon Press Ltd.
DOI: 10.1016/j.ejca.2024.114339

Impact of recruitment method on informed decision-making in lung cancer screening in the 4-IN-THE-LUNG-RUN trial

Author(s): Juul Hubert, Dana Moldovanu, Isabelle van den Bosch, Koen de Nijs, Kevin ten Haaf, Matthijs Oudkerk, Harry J. de Koning, Carlijn M. van der Aalst
Published in: Lung Cancer, Issue 207, 2025, Page(s) 108686, ISSN 0169-5002
Publisher: Elsevier BV
DOI: 10.1016/j.lungcan.2025.108686

Histological proven AI performance in the UKLS CT lung cancer screening study: Potential for workload reduction

Author(s): Harriet L. Lancaster, Beibei Jiang, Michael P.A. Davies, Jan Willem C. Gratama, Mario Silva, Jaeyoun Yi, Marjolein A. Heuvelmans, Geertruida H. de Bock, Anand Devaraj, John K. Field, Matthijs Oudkerk
Published in: European Journal of Cancer, Issue 220, 2025, Page(s) 115324, ISSN 0959-8049
Publisher: Pergamon Press Ltd.
DOI: 10.1016/j.ejca.2025.115324