ALIA Kuwait: A Prospective Pilot Feasibility Study of Low-Dose Computed Tomography Screening for Lung Cancer in High-Risk Individuals in Kuwait
Lung cancer is a leading cause of cancer-related death in Kuwait, where most cases are diagnosed at an advanced stage and there is no national screening program. This prospective pilot feasibility study will offer low-dose computed tomography (LDCT) screening to approximately 500 high-risk individuals aged 50-80 years across Kuwait. The primary objective is to assess the uptake of, and barriers to, LDCT lung cancer screening in Kuwait and to establish a framework for a national screening program. Participants undergo eligibility assessment (smoking history of at least 20 pack-years, totalled across all tobacco products using pre-specified equivalency conversions for shisha/waterpipe, cigar, pipe, and roll-your-own tobacco), baseline assessment, LDCT screening with Lung-RADS-based management, a second screening round at 12 months, and follow-up. LDCT images are read by radiologists and in parallel by artificial intelligence (AI) software to evaluate AI-assisted reading. Findings will inform national lung cancer screening guidelines for Kuwait.
Inclusion Criteria: * Age 50 to 80 years * Smoking history of at least 20 pack-years, totalled across all tobacco products using pre-specified equivalency conventions (1 shisha head-year = 1 pack-year; 1 cigar = 4 cigarettes; 1 pipe bowl = 2.5 cigarettes; roll-your-own tobacco 1 g = 1 cigarette). Current and former smokers are eligible regardless of time since quitting. * Able to provide informed consent
Exclusion Criteria: * Previous diagnosis of lung cancer * Currently under surveillance for pulmonary nodules * Currently undergoing diagnostic assessment, treatment, or surveillance for major comorbidities * Unable to lie flat with arms raised above the head for CT scanning * Symptoms suggestive of lung cancer (persistent or worsening cough, haemoptysis, or unexplained weight loss of more than 7 kg in the past year)
[{"measure":"Consent rate (co-primary outcome P1)","timeFrame":"12 months from start of recruitment"},{"measure":"Baseline LDCT scan completion rate (co-primary outcome P2)","timeFrame":"15 months from start of recruitment (12-month recruitment period plus 90-day scan-completion window)"}]