Under the section "Gastrointestinal toxicity: Gastrointestinal toxicity of anti-CTLA4 antibodies: Diagnosis"The sigmoid colon and the rectum are involved in most cases; therefore, a flexible sigmoidoscopy is generally sufficient to make the diagnosis of anti-CTLA4-induced enterocolitis [38]. Is replaced with:The sigmoid colon and the rectum are involved in most cases; therefore, a flexible sigmoidoscopy is generally sufficient to make the diagnosis of anti-CTLA4-induced enterocolitis [38,42].Under the section "Gastrointestinal toxicity: Gastrointestinal toxicity of anti-CTLA4 antibodies: Management" Overall, one-third to two-thirds of patients either do not respond to high-dose i.v. steroids, or have a relapse requiring an increase in the corticosteroid dosage during the course of steroid tapering. These patients require infliximab and usually have an excellent response. A single dose of infliximab (5mg/kg) is generally sufficient [18, 35, 36, 38]. Is replaced with:Overall, one-third to two-thirds of patients either do not respond to high-dose i.v. steroids, or have a relapse requiring an increase in the corticosteroid dosage during the course of steroid tapering [38,42]. These patients require infliximab and usually have an excellent response. A single dose of infliximab (5mg/kg) is generally sufficient [18, 35, 36, 38,42].

BackgroundLung cancer screening using low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial.MethodsThe pilot UK Lung Cancer Screening (UKLS) is a randomised controlled trial of LDCT screening for lung cancer versus usual care. A population-based questionnaire was used to identify high-risk individuals. CT screen-detected nodules were managed by a pre-specified protocol. Cost effectiveness was modelled with reference to the National Lung Cancer Screening Trial mortality reduction.Results247 354 individuals aged 50–75 years were approached; 30.7% expressed an interest, 8729 (11.5%) were eligible and 4055 were randomised, 2028 into the CT arm (1994 underwent a CT). Forty-two participants (2.1%) had confirmed lung cancer, 34 (1.7%) at baseline and 8 (0.4%) at the 12-month scan. 28/42 (66.7%) had stage I disease, 36/42 (85.7%) had stage I or II disease. 35/42 (83.3%) had surgical resection. 536 subjects had nodules greater than 50 mm3 or 5 mm diameter and 41/536 were found to have lung cancer. One further cancer was detected by follow-up of nodules between 15 and 50 mm3 at 12 months. The baseline estimate for the incremental cost-effectiveness ratio of once-only CT screening, under the UKLS protocol, was £8466 per quality adjusted life year gained (CI £5542 to £12 569).ConclusionsThe UKLS pilot trial demonstrated that it is possible to detect lung cancer at an early stage and deliver potentially curative treatment in over 80% of cases. Health economic analysis suggests that the intervention would be cost effective—this needs to be confirmed using data on observed lung cancer mortality reduction.Trial registrationISRCTN 78513845.

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