Expert Profile

Professor He Jianxing
- Director, National Center for Respiratory Medicine
- President, Guangzhou Institute of Respiratory Health
- Academic Lead in Thoracic Surgery, Transplantation, and Oncology, First Affiliated Hospital of Guangzhou Medical University
- Fellow, American College of Surgeons and Royal College of Surgeons (UK)
- Recipient of numerous national awards, including:
  ? Second-Class National Science and Technology Progress Award (2018)
  ? First-Class National Science and Technology Progress Award (2020)
  ? National Innovation and Excellence Team Award (2021)
  ? National Individual Innovation and Excellence Award (2023)
  ? First-Class Chinese Medical Science Award (2017), Huaxia Medical Award
- 10th Shulan Medical Award Laureate; Guangdong Provincial Science and Technology Grand Prize (2021)
- Recognized as one of China’s Top Ten Reputable Physicians; Distinguished Young Expert by the Ministry of Health
- First Prize in the National Thoracic Surgery Standardization and Innovation Showcase (Complex Lung and Mediastinal Surgery Group)

Lung Cancer: A National Challenge

Lung cancer remains one of the most prevalent and deadly malignancies in China. According to the National Cancer Center, approximately two individuals are diagnosed with lung cancer every minute, and around 1.4 die from it. The “Healthy China 2030” initiative emphasizes a shift from disease-centered to health-centered care, with lung cancer screening and early detection forming a cornerstone of this transformation.

From High-Risk to Population-Based Screening: 1990s–2010s

Professor He noted that his team began lung cancer screening research in 1994 under the guidance of Academician Zhong Nanshan, initially in Zhuhai and subsequently expanding to Shenzhen in 1995. Over the next 20 years, their efforts focused on both high-risk and non–high-risk populations. Clinical observations revealed that while screening high-risk individuals was effective, a substantial number of lung cancer cases were still found among non–high-risk populations.
In 2015, leveraging two decades of accumulated data and experience, the team launched a large-scale screening program targeting low-income individuals over 50 in Guangzhou—marking the first major attempt at non–risk-based screening in China.
By 2017, the team introduced the “Lung Care Project” in Yuexiu District, screening residents aged 50–74. In 2022, they launched the “Ten Thousand People Screening Program,” followed by the “Lung Health Program” in 2024, significantly expanding the scope and scale of screening. This journey has spanned over 30 years.
Professor He also acknowledged the global influence of the Early Lung Cancer Action Project (ELCAP) initiated by Professor Henschke in 1992. His team paralleled these international efforts and published significant findings in Lung Cancer in 2011, contributing to China's foundational work in CT-based lung cancer screening.

Technical Evolution and Infrastructure Support

Traditional chest X-rays proved inadequate in detecting early-stage lung cancer. The adoption of low-dose spiral CT has since become the gold standard. As CT technology matured and costs declined, China's healthcare system experienced a dramatic increase in CT scanner availability—from a scarcity in the 1990s to over 45,000 units today, surpassing the U.S. (15,000 units) and EU (21,000 units), enabling large-scale screening.

The Lung Care Project: Background, Design, and Goals

In 2015, supported by local charitable organizations, the team provided free early screening to over 1,300 low-income individuals aged over 50 in Guangzhou, detecting 17 cases of lung cancer with a detection rate of 1.3%, most in early stages. These findings led to the formulation of the “Lung Care Project.”
At the time, global guidelines favored selective screening for high-risk individuals. However, based on successful chronic disease screening strategies, Professor He’s team advocated for universal screening.
While randomized controlled trials supported CT screening for heavy smokers, data showed that non-smokers in Asia also faced high lung cancer risks. The team applied a risk-stratified approach to screening and achieved promising early results.
Screening requires extensive resources—CT machines, trained personnel, and community engagement. The second screening phase focused on individuals aged 50–70.
Published in the Journal of Thoracic Oncology, their study demonstrated that current guidelines miss most lung cancer patients, especially in early stages, prompting a proposal for a new universal screening model. The National Health Commission has since adapted policy based on their findings.

Project Design Highlights

Inclusion Criteria:
- Permanent residents of Guangzhou aged 40–74
Exclusion Criteria:
- History of lung cancer or surgery
- CT scan within the past year
- Obvious symptoms suggestive of lung cancer
- Inability to undergo CT scanning

The project involved expert-led protocol development, including questionnaires, community outreach, and education campaigns.

Primary Objective:
- Assess lung cancer prevalence in Guangzhou pilot populations and compare rates between high- and low-risk groups

Secondary Objectives:
- Identify lung cancer risk factors in the Chinese population
- Conduct economic evaluations to ensure cost-effectiveness of resource-intensive screening

New Universal Screening Model: Scaling and Innovation

With multi-source support, the team transitioned from the “Lung Care Project” to the broader “Lung Health Program,” aiming to establish a national screening network. Their strategy draws on the successful chronic disease prevention model—advocating universal over selective screening—while incorporating innovative technologies for efficiency and affordability.

Emerging Technologies in Lung Cancer Screening

- ctDNA Methylation Testing: Used as a diagnostic tool following initial screening to improve specificity.

- Big Data & Biobank Development: Leveraging the National Center for Respiratory Medicine, the team established a nationwide network of 136 hospitals across 29 provinces, including biospecimen banks and health data management systems. This supports the CACA's focus on the full cancer care continuum: Screening–Diagnosis–Treatment–Recovery. The current cohort includes over 900,000 individuals.

AI-Powered Innovations

Professor He’s team has developed China's first AI-powered full-chest diagnostic platform for early-stage lung cancer, capable of screening for 15 thoracic diseases in one scan. This system enhances accuracy, scalability, and standardization across facilities.

Additional innovations include:
- AI-assisted visual diagnosis devices (in partnership with Academician Cheng Jing)
- VOCDIAG: A breath-based diagnostic system aimed at reducing screening costs to 50–100 RMB
- AI-based pathology models, educational animations, and a suite of 21 AI tools supporting prevention, screening, diagnosis, treatment, and recovery.