Global development and validation of the Lung Cancer Prevention Score (LCPS): A quantitative framework linking policy strength, incidence, and outcomes across 40 countries.

10518 Background: Lung cancer is the leading cause of cancer worldwide. Despite advances in tobacco control, national prevention efforts remain fragmented. We developed and validated the Lung Cancer Prevention Score (LCPS), a 0–100 composite linking prevention policy strength with real-world outcomes for global benchmarking and equity tracking. Methods: Two LCPS models were created. Policy LCPS quantified 12 weighted domains: smoke-free laws, TAPS bans, ≥50% pictorial warnings, ≥75% excise tax, plain packaging, legal-age limits, e-cigarette control, LDCT screening, asbestos ban, radon plan, clean-cooking access, and occupational carcinogen controls. Data-Driven LCPS combined age-standardized incidence (ASIR), mortality (ASMR), mortality-to-incidence ratio (MIR), smoking prevalence, GDP, health expenditure, and HDI (normalized 0–1; higher = stronger prevention). Data from GLOBOCAN 2022, WHO GTCR 2023, World Bank, and UNDP HDR 2023 covered 40 countries (G20 + 20 others). Analyses included correlation, regression (adjusted for GDP, HDI), Bland–Altman agreement, and ROC AUC for MIR ≤0.60. Results: Among 32 complete datasets, Policy and Data-Driven LCPS correlated moderately (r = 0.31; 95% CI –0.04–0.60). Discrimination of favorable outcomes (MIR ≤0.60) showed AUC 0.68 vs 0.77. High-policy countries (≥75) had lower smoking (17%) and MIR (0.45) than those 90 % P 1 Yes = 1 Occ carcinogen ctrl P 1.5 Yes = 1 ASIR D 1 Lower = better (1–scaled ASIR) ASMR D 1 Lower = better (1–scaled ASMR) MIR D 1 Lower = better (1–scaled MIR) Smoking prev D 1</ja