Background: Epidemiological studies demonstrated that patients with asbestosis have a 6× increased risk of developing lung cancer and people who smoke have an 11× increased risk of developing lung cancer. However, people who are diagnosed with asbestosis and smoke have a 59× increased risk of developing lung cancer. Several high quality systematic reviews and recent randomized controlled trials showed that screening these high risk individuals with low does chest CT scanning may lead to early detection and treatment of lung cancers. At present, WorkSafeBC has approximately 200 workers that have been diagnosed with asbestosis and the vast majority of these workers are smokers or ex-smokers.

Objectives: - To describe evidence-based policy development in the area of occupational medicine - to describe the process and implementation of such policy - to describe early outcome of this policy.

Methods: Systematic review based business proposal was developed by concerned departments at WorkSafeBC and presented to the senior executives for funding approval. - Outside stakeholders, including the BC Cancer Agency, were identified and engaged in the development of the screening protocol. - Upon senior executives’ approval, the program was implemented and outcome monitoring is ongoing.

Results: - Low dose CT lung cancer screening program among workers exposed to asbestos started in January 1, 2013 is ongoing - Development process of this screening project, incl. the evidence-based protocol, will be described as well as the early outcomes.

Conclusions: Among workers exposed to asbestos, low dose CT scan screening is effective in detecting lung cancer at early stage, provides better quality of life to workers and cost-effective to WorkSafeBC.