| 1. Minimize psychological, physical and radiation-associated harm |
| 2. Cost-effectiveness |
| 3. Recruitment and eligibility: optimal risk model |
| 4. Participation and compliance in underserved high risk populations |
| 5. Workforce and capacity: CT-scan, radiologists, thoracic surgeons, radiation apparatus, oncology nurses |
| 6. Service implementation and quality assurance |
| 7. Additional health interventions: e.g., smoking cessation, COPD and cardiac comorbidity |
| 8. Incidental findings: emphysema, mediastinal tumours, coronary artery calcifications, interstitial lung fibrosis, etc. |
| 9. Overdiagnosis and false positive rate |
| 10. Lack of patient and clinician awareness |
