低剂量 CT (LDCT) 的引入改变了肺癌 (LC) 筛查的格局，并有助于降低全球死亡率。在此，我们报告匈牙利最大的基于人群的LDCT筛查项目HUNCHEST-II的最终结果，包括筛查和诊断结果以及LC病例的特征。总共4215名年龄在50岁至75岁之间的高危人群具有至少 25 包年吸烟史的年份被分配接受 LDCT 筛查。筛查结果根据肺结节或肿块的体积、生长和体积倍增时间确定。将筛查检测到的癌症的临床分期分布与两个由未经筛查的 LC 患者组成的独立的基于实践的数据库进行比较。基线时阴性和不确定测试的百分比分别为 74.2% 和 21.7%，而阳性 LDCT 结果的发生率为4.1%。总体而言，在整个筛查过程中，有 76 名 LC 患者被诊断出来（占参与者总数的 1.8%），其中 62 名患者（占参与者总数的 1.5%）已在第一轮筛查中被确诊。阳性检测的总体阳性预测值为 58%。大多数筛查检测到的恶性肿瘤为 I 期 LC（60.7%），所有病例中只有 16.4% 可归类为 IV 期疾病。 HUNCHEST-II 筛查检测到的个体中早期恶性肿瘤的百分比显着高于国家 Koranyi 肺病研究所档案或匈牙利癌症登记处的 LC 患者 (p < 0.001)。HUNCHEST-II 表明 LDCT 筛查LC 有助于早期诊断，因此支持在匈牙利引入系统 LC 筛查。HUNCHEST-II 是匈牙利迄今为止最大的基于人群的低剂量 CT 筛查计划。阳性检测的总体阳性预测值为 58%，大多数筛查检测到的恶性肿瘤都是早期病变。这些结果为该地区广泛的系统筛查铺平了道路。• HUNCHEST-II 在 18 个医疗机构进行，是匈牙利迄今为止最大的基于人群的低剂量 CT 筛查项目。 • 绝大多数筛查发现的恶性肿瘤是早期肺癌，阳性检测的总体阳性预测值为58%。 • HUNCHEST-II 有助于早期诊断，因此支持在匈牙利引入系统性肺癌筛查。© 2023。作者，获得欧洲放射学会的独家许可。

The introduction of low-dose CT (LDCT) altered the landscape of lung cancer (LC) screening and contributed to the reduction of mortality rates worldwide. Here we report the final results of HUNCHEST-II, the largest population-based LDCT screening program in Hungary, including the screening and diagnostic outcomes, and the characteristics of the LC cases.A total of 4215 high-risk individuals aged between 50 and 75 years with a smoking history of at least 25 pack-years were assigned to undergo LDCT screening. Screening outcomes were determined based on the volume, growth, and volume doubling time of pulmonary nodules or masses. The clinical stage distribution of screen-detected cancers was compared with two independent practice-based databases consisting of unscreened LC patients.The percentage of negative and indeterminate tests at baseline were 74.2% and 21.7%, respectively, whereas the prevalence of positive LDCT results was 4.1%. Overall, 76 LC patients were diagnosed throughout the screening rounds (1.8% of total participants), out of which 62 (1.5%) patients were already identified in the first screening round. The overall positive predictive value of a positive test was 58%. Most screen-detected malignancies were stage I LCs (60.7%), and only 16.4% of all cases could be classified as stage IV disease. The percentage of early-stage malignancies was significantly higher among HUNCHEST-II screen-detected individuals than among the LC patients in the National Koranyi Institute of Pulmonology's archive or the Hungarian Cancer Registry (p < 0.001).HUNCHEST-II demonstrates that LDCT screening for LC facilitates early diagnosis, thus arguing in favor of introducing systematic LC screening in Hungary.HUNCHEST-II is the so-far largest population-based low-dose CT screening program in Hungary. A positive test's overall positive predictive value was 58%, and most screen-detected malignancies were early-stage lesions. These results pave the way for expansive systematic screening in the region.• Conducted in 18 medical facilities, HUNCHEST-II is the so far largest population-based low-dose CT screening program in Hungary. • The vast majority of screen-detected malignancies were early-stage lung cancers, and the overall positive predictive value of a positive test was 58%. • HUNCHEST-II facilitates early diagnosis, thus arguing in favor of introducing systematic lung cancer screening in Hungary.© 2023. The Author(s), under exclusive licence to European Society of Radiology.