Lung Screen Uptake Trial: results from a single lung cancer screening round

Quaife, Samantha L; Dickson, Jennifer; Horst, Carolyn; Tisi, Sophie; Hall, Helen; Taylor, Magali; Ahmed, Asia; Shaw, Penny; Burke, Stephen; Soo, May-Jan; Nair, Arjun; Devaraj, Anand; Sennett, Karen; Duffy, Stephen W.; Navani, Neal; Bhowmik, Angshu; Baldwin, David R; Janes, Sam M.

doi:10.1136/thoraxjnl-2020-214703

Cited by 15 publications

(12 citation statements)

References 18 publications

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“…The reality was always that the health benefits were likely to be the same but the costs lower. Evidence from the NELSON study, and UK-based trials 11,34,69 and services, including the SUMMIT study, the Yorkshire Lung Screening Trial and the NHS England Lung Health check pilots, will continue to refine our understanding of how to implement LCS in Europe.…”

Section: Discussionmentioning

confidence: 99%

Hesitancy around low-dose CT screening for lung cancer

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Hesitancy around low-dose CT screening for lung cancer

et al. 2022

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“… 5 Following the success of the UKLS trial, several pilot programmes began in the UK including the Liverpool Health Lung Project and Lung Screen Uptake Trial. 13 , 14 The Targeted Lung Health Check Programme has since been introduced in 10 regions in the UK and invites individuals aged 55 to 74 and 364 days of age that are registered with a GP who have ever smoked to a Lung Health Check. 15 Attendees with a LLP v2 risk ≥2.5% over 5 years and/or PLCO risk ≥1.51% over 6 years are invited for LDCT.…”

Section: Defining and Selecting The Eligible Populationmentioning

confidence: 99%

The Future of Lung Cancer Screening: Current Challenges and Research Priorities

Burzić¹,

O’Dowd²,

Baldwin³

2022

CMAR

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Lung cancer is the leading cause of cancer-related deaths worldwide, primarily because most people present when the stage is too advanced to offer any reasonable chance of cure. Over the last two decades, evidence has accumulated to show that early detection of lung cancer, using low-radiation dose computed tomography, in people at higher risk of the condition reduces their mortality. Many countries are now making progress with implementing programmes, although some have concerns about cost-effectiveness. Lung cancer screening is complex, and many factors influence clinical and cost-effectiveness. It is important to develop strategies to optimise each element of the intervention from selection and participation through optimal scanning, management of findings and treatment. The overall aim is to maximise benefits and minimise harms. Additional integrated interventions must include at least smoking cessation. In this review, we summarize the evidence that has accumulated to guide optimisation of lung cancer screening, discuss the remaining open questions about the best approach and identify potential barriers to successful implementation.

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“…This study is an a priori sub-study of the Lung Screen Uptake Trial (LSUT) ( 17 ). LSUT recruited individuals aged 60–75 years to undergo a single round of LDCT screening if meeting either the United States Preventive Services Task Force (USPSTF) threshold (≥ 30 pack years smoking history, and quit ≤ 15 years ago), or the Liverpool Lung Project (LLP) or the Prostate Lung Colorectal and Ovarian (PLCO m2012 ) lung cancer risk model thresholds (≥ 2.5% over 5 years and ≥ 1.51% over 6 years respectively) ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

The role of computer-assisted radiographer reporting in lung cancer screening programmes

et al. 2022

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Objectives Successful lung cancer screening delivery requires sensitive, timely reporting of low-dose computed tomography (LDCT) scans, placing a demand on radiology resources. Trained non-radiologist readers and computer-assisted detection (CADe) software may offer strategies to optimise the use of radiology resources without loss of sensitivity. This report examines the accuracy of trained reporting radiographers using CADe support to report LDCT scans performed as part of the Lung Screen Uptake Trial (LSUT). Methods In this observational cohort study, two radiographers independently read all LDCT performed within LSUT and reported on the presence of clinically significant nodules and common incidental findings (IFs), including recommendations for management. Reports were compared against a ‘reference standard’ (RS) derived from nodules identified by study radiologists without CADe, plus consensus radiologist review of any additional nodules identified by the radiographers. Results A total of 716 scans were included, 158 of which had one or more clinically significant pulmonary nodules as per our RS. Radiographer sensitivity against the RS was 68–73.7%, with specificity of 92.1–92.7%. Sensitivity for detection of proven cancers diagnosed from the baseline scan was 83.3–100%. The spectrum of IFs exceeded what could reasonably be covered in radiographer training. Conclusion Our findings highlight the complexity of LDCT reporting requirements, including the limitations of CADe and the breadth of IFs. We are unable to recommend CADe-supported radiographers as a sole reader of LDCT scans, but propose potential avenues for further research including initial triage of abnormal LDCT or reporting of follow-up surveillance scans. Key Points • Successful roll-out of mass screening programmes for lung cancer depends on timely, accurate CT scan reporting, placing a demand on existing radiology resources. • This observational cohort study examines the accuracy of trained radiographers using computer-assisted detection (CADe) software to report lung cancer screening CT scans, as a potential means of supporting reporting workflows in LCS programmes. • CADe-supported radiographers were less sensitive than radiologists at identifying clinically significant pulmonary nodules, but had a low false-positive rate and good sensitivity for detection of confirmed cancers.

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Lung Screen Uptake Trial: results from a single lung cancer screening round

Cited by 15 publications

References 18 publications

Hesitancy around low-dose CT screening for lung cancer

Hesitancy around low-dose CT screening for lung cancer

The Future of Lung Cancer Screening: Current Challenges and Research Priorities

The role of computer-assisted radiographer reporting in lung cancer screening programmes

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