Second round results from the Manchester ‘Lung Health Check’ community-based targeted lung cancer screening pilot

Crosbie, Philip; Balata, Haval; Evison, Matthew; Atack, Melanie; Bayliss-Brideaux, Val; Colligan, Denis; Duerden, Rebecca; Eaglesfield, Josephine; Edwards, Timothy L.; Elton, Peter; Foster, Julie; Greaves, Melanie; Hayler, Graham; Higgins, Coral; Howells, John; Irion, Klaus; Karunaratne, Devinda; Kelly, Jodie; King, Zoe; Lyons, Judith; Manson, Sarah; Mellor, Stuart; Miller, Donna; Myerscough, Amanda; Newton, Tom; O’Leary, Michelle; Pearson, R.; Pickford, Julie; Sawyer, Rachel; Screaton, Nick; Sharman, Anna; Simmons, Maggi; Smith, Elaine; Taylor, Ben; Taylor, Sarah H.; Walsham, Anna; Watts, Angela; Whittaker, J.; Yarnell, Laura; Threlfall, Anthony; Barber, Philip; Tonge, Janet; Booton, Richard

doi:10.1136/thoraxjnl-2018-212547

Cited by 68 publications

(70 citation statements)

References 10 publications

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“…There is a need for further follow-up of all subjects undergoing health checks to assess the extent to which the risk eligibility criteria and the diagnostic algorithm might be causing cancers to be missed. Both the low rate of further investigations following a CT scan and the promising results with respect to stage of disease are consistent with results from a similar project in Manchester [42].…”

Section: Discussionsupporting

confidence: 85%

Evaluation of a health service adopting proactive approach to reduce high risk of lung cancer: The Liverpool Healthy Lung Programme

et al. 2019

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This Liverpool Healthy Lung Programme is a response to high rates of lung cancer and respiratory diseases locally and aims to diagnose lung cancer at an earlier stage by proactive approach to those at high risk of lung cancer. The objective of this study is to evaluate the programme in terms of its likely effect on mortality from lung cancer and its delivery to deprived populations. Methods Persons aged 58-75 years, with a history of smoking or a diagnosis of chronic obstructive pulmonary disease (COPD) 1 according to general practice records were invited for lung health check in a community health hub setting. A detailed risk assessment and spirometry were performed in eligible patients. Those with a 5% or greater five-year risk of lung cancer were referred for a low dose CT 2 scan. Results A total of 4 566 subjects attended the appointment for risk assessment and 3 591 (79%) consented to data sharing. More than 80% of the patients were in the most deprived quintile of the index of multiple deprivation. Of those attending, 63% underwent spirometry and 43% were recommended for a CT scan. A total of 25 cancers were diagnosed, of which 16 (64%) were stage I. Comparison with the national stage distribution implied that the programme was reducing lung cancer mortality by 22%. Conclusions 1 COPD, chronic obstructive pulmonary disease; 2 CT, computed tomography 3 Community based proactive approaches to early diagnosis of lung cancer in health deprived regions are likely to be effective in early detection of lung cancer.

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Section: Discussionsupporting

confidence: 85%

Evaluation of a health service adopting proactive approach to reduce high risk of lung cancer: The Liverpool Healthy Lung Programme

et al. 2019

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“…Furthermore, having adopted the latest British Thoracic Society nodule management guidelines, the Manchester investigators report an overall false-positive rate of 3.5% (0.8% in the second round), defined as a proportion of the screened population as a whole, and a benign surgical resection rate of 2.5% (one case). 59,60 The encouraging results from these pilot studies have led to strong support from NHS England with a recent announcement of plans to rollout similar programs across the country. 61 In Asia, LDCT lung cancer screening is still under consideration as the incidence of lung cancer among never-smokers is higher compared to Europe and North America.…”

Section: Image-based Screeningmentioning

confidence: 99%

Prevention and Early Detection for NSCLC: Advances in Thoracic Oncology 2018

Balata

Fong

Hendriks

et al. 2019

Journal of Thoracic Oncology

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Lung cancer remains the leading cause of cancer-related mortality worldwide. Tobacco consumption remains the most important risk factor. Although the prevalence of smoking has decreased overall, it continues to be a significant burden for global health. It is estimated that there are still nearly 1 billion cigarette smokers worldwide. Prevention strategies have largely focused on tobacco control and prevention. However, we have witnessed a dramatic increase in the use of e-cigarettes and other vaping products. Primary chemoprevention has historically not been a successful strategy for lung cancer; however, focused approaches in specific groups of patients at high risk for development of lung cancer are underway. The majority of cases with NSCLC are diagnosed with locally advanced or metastatic disease, where the overall prognosis remains very poor. Early-stage NSCLC on the other hand has a much better prognosis and can usually be treated radically with either surgical resection or radical radiotherapy, with relatively favorable long-term outcomes. In addition to image-based screening, other methods such as breath-based and biofluidbased approaches are now being investigated for early detection of NSCLC. This review will focus on recent advancements in the field of prevention, screening, and early detection of NSCLC.

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“…Older case series of larger nodules prior to the introduction of more rigorous pre-operative risk stratification reported benign resection rates of 9–64% but application of the BTS guidelines has reduced this to below 5%. 6 The most common histological findings following resection of a benign lesion were granulomas, chondromas/hamartomas, intrapulmonary lymph nodes, fibrosis and inflammatory lesions including pneumonia, abscess and aspergillomas. 7–12 …”

Section: Causes Of Pulmonary Nodulesmentioning

confidence: 99%