UK Lung Cancer Screening Trial: – First 1000 recruits


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John Field1, David Baldwin2, Stephen Duffy3, John Holemans4, Martin Ledson4, Nicholas Screaton5, Robert C. Rintoul5, David Hansell7, Anand Devaraj6
1The University of Liverpool, Liverpool, UK, 2Nottingham University Hospital, Nottingham, UK, 3Barts & London University, London, UK, 4Liverpool Heart & Chest Hospital, Liverpool, UK, 5Papworth Hospital, Cambridge, UK, 6St Georges Hospital, London, UK, 7Royal Brompton Hospital, London, UK

Background

The aim of the UK Lung cancer Screening trial (UKLS) is to determine whether low dose CT screening reduces mortality in the UK[1]; to measure benefit and harms; and estimate cost effectiveness

Method

The pilot sites are in Liverpool and Papworth, with a second reading site at the Royal Brompton Hospital. The pilot UKLS will randomise 4,000 people who have at least a 5% risk of developing lung cancer over 5 years as predicted by the Liverpool Lung project (LLP) risk model [2]. If progression criteria are met and funding is available, a further 28,000 people will be randomised. The “Wald Single Screen” Design has been chosen for the UKLS pilot trial [3]. Individuals meeting the inclusion/exclusion criteria attend one of the pilot recruitment sites. After consent, spirometry, specimen collection, and completing a questionnaire, they are randomised either to a single low dose CT in the study arm or to the control arm with no CT. Volumetric analysis is performed on CT detected nodules. Both groups are followed-up in the same way by questionnaires and for lung cancer incidence and mortality

Results

Since the start of the UKLS pilot recruitment in autumn 2011, 1000 individuals have been recruited and consented. 400 have had a CT and 15 have been referred to MDT clinics with nodules suspicious for lung cancer [3]. Nine individuals with incidental but significant non-lung cancer findings have been identified1

Conclusion

The UKLS pilot is in the recruiting phase and has already identified individuals who may benefit from CT screening. The trial is on its way to answering the question whether screening by low dose CT will confer a mortality advantage of 30% and also be cost effective for the UK population.