The Propulmão project: a multifaceted approach to lung cancer prevention and early detection

The Propulmão project

The Propulmão project is a major health initiative established to improve prevention, early detection and screening of lung cancer, and it aims to reduce the burden of lung cancer in Brazil. It includes the following activities:

1. Early detection and screening: the primary focus of the project is to use low-dose computed tomography (LDCT) to screen high-risk individuals for lung cancer.
2. Education and professional training: Propulmão conducts training activities for healthcare professionals throughout Brazil, to improve their skills in lung cancer prevention and early detection.
3. Public health initiatives: the project engages in primary prevention activities such as smoking cessation programmes, given the high incidence of smoking-related lung cancer in Brazil.
4. Research: the publication of research, such as the BRELT1 and BRELT2 studies, supports the feasibility and effectiveness of LDCT screening in Brazil, taking into account local challenges.
5. Mobile screening unit: known as the Respiratory Health Trailer or Mobile Propulmão, this mobile unit is specifically designed to carry out lung cancer screening.
6. Community outreach: through its website and the mobile unit, Propulmão extends its reach to the community, providing a range of services.
7. Collaboration: the project collaborates with various medical institutions, the pharmaceutical industry and specialists, including international organisations such as the International Early Lung Cancer Action Program (I-ELCAP).
8. Policy and healthcare system integration: Propulmão works with the Sistema Único de Saúde (Brazilian Unified Health System) to implement lung cancer screening by creating new processes and tools for healthcare professionals.

The Propulmão project aims to improve equity and access to lung cancer screening, particularly for populations in rural or underserved areas, by ensuring that lung cancer screening and prevention resources are developed to address the needs of these communities.
 

Could you share with us the key outcomes of the lung cancer screening programme?

So far, 4,701 individuals have registered for the lung cancer screening programme, and 1,847 of them met the eligibility criteria and 1,497 were screened using LDCT in the mobile unit. It was found that 63% of people screened were at high risk of developing lung cancer in the next six years, as assessed using a risk-prediction mode.
 

Are there key learnings from the Propulmão project so far?

There have been many learnings from the project, with improving the delivery of resources and strengthening engagement with the target populations, both vital to future iterations. Project leaders have identified several key areas for improvement, such as enhancing outreach and education, optimising screening processes by refining screening criteria or protocols, and integrating technology. These areas sit alongside long-term considerations for the scalability of the project to other parts of Brazil, and the need for effective evaluation methods. Adapting the project based on these learnings could significantly enhance its impact, reach and sustainability, ultimately leading to better health outcomes for the target population.