Evaluation of a service adopting a proactive approach to high risk of lung cancer: The Liverpool Healthy Lung Programme
Session type: Poster / e-Poster / Silent Theatre session
Lung cancer is the leading cause of cancer death in the United Kingdom with lower survival rates in patients of lower socioeconomic status than their more affluent counterparts. Community based health services addressing subjects at high risk of lung cancer may be effective in reducing lung disease morbidity and mortality. The Liverpool Healthy Lung Programme is such an initiative.
Patients aged 58-75 years, with a history of smoking or a diagnosis of chronic obstructive pulmonary disease (COPD) according to general practice records, were invited for a lung health check in a community health hub setting. A detailed risk assessment, a spirometry test and a low-dose computed tomography (CT) scan were performed when patients were judged to be above a specific threshold of lung cancer risk. Consent was requested from the participants to share their data for evaluation purposes. During analysis, demographics, risk factors and clinical attributes of patients were compared between the most deprived IMD quintile and the four remaining IMD quintiles using logistic regression. The stage distribution of lung cancers diagnosed was compared to the national stage distribution using the chi-squared test.
A total of 4,566 patients attended the appointment between April 2016 and January 2018 and 3,591 (79%) consented to data sharing. More than 80% of the patients were in the most deprived category. Of those attending, 63% underwent spirometry and 43% were recommended for a CT scan. The 5-year risk of lung cancer was found to be greater in the most deprived group (p=0.0005). A total of 25 cancers were diagnosed during this study, of which 16 (64%) were stage I.
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 and possibly COPD.