UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening

J K Field; S W Duffy; D R Baldwin; D K Whynes; A Devaraj; K E Brain; T Eisen; J Gosney; B A Green; J A Holemans; T Kavanagh; K M Kerr; M Ledson; K J Lifford; F E McRonald; A Nair; R D Page; M K B Parmar; D M Rassl; R C Rintoul; N J Screaton; N J Wald; D Weller; P R Williamson; G Yadegarfar; D M Hansell

doi:10.1136/thoraxjnl-2015-207140

UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening

J K Field, S W Duffy, D R Baldwin, D K Whynes, A Devaraj, K E Brain, T Eisen, J Gosney, B A Green, J A Holemans, T Kavanagh, K M Kerr, M Ledson, K J Lifford, F E McRonald, A Nair, R D Page, M K B Parmar, D M Rassl, R C RintoulN J Screaton, N J Wald, D Weller, P R Williamson, G Yadegarfar, D M Hansell

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Lung cancer screening using low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial.

METHODS: The 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.

RESULTS: 247 354 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 mm(3) 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 mm(3) 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).

CONCLUSIONS: The 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 REGISTRATION: ISRCTN 78513845.

Original language	English
Pages (from-to)	161-170
Number of pages	10
Journal	Thorax
Volume	71
Issue number	2
Early online date	8 Dec 2015
DOIs	https://doi.org/10.1136/thoraxjnl-2015-207140
Publication status	Published - 1 Feb 2016

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10.1136/thoraxjnl-2015-207140

Weller D UK Lung Cancer
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
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https://thorax.bmj.com/content/71/2/161

David Weller
- Deanery of Molecular, Genetic and Population Health Sciences - James Mackenzie Chair of General Practice
- Global Health Academy
- Usher Institute
- Centre for Population Health Sciences
Person: Academic: Research Active

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Field, J. K., Duffy, S. W., Baldwin, D. R., Whynes, D. K., Devaraj, A., Brain, K. E., Eisen, T., Gosney, J., Green, B. A., Holemans, J. A., Kavanagh, T., Kerr, K. M., Ledson, M., Lifford, K. J., McRonald, F. E., Nair, A., Page, R. D., Parmar, M. K. B., Rassl, D. M., ... Hansell, D. M. (2016). UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening. Thorax, 71(2), 161-170. https://doi.org/10.1136/thoraxjnl-2015-207140

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title = "UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening",

abstract = "BACKGROUND: Lung cancer screening using low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial.METHODS: The 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.RESULTS: 247 354 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 mm(3) 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 mm(3) 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).CONCLUSIONS: The 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 REGISTRATION: ISRCTN 78513845.",

author = "Field, {J K} and Duffy, {S W} and Baldwin, {D R} and Whynes, {D K} and A Devaraj and Brain, {K E} and T Eisen and J Gosney and Green, {B A} and Holemans, {J A} and T Kavanagh and Kerr, {K M} and M Ledson and Lifford, {K J} and McRonald, {F E} and A Nair and Page, {R D} and Parmar, {M K B} and Rassl, {D M} and Rintoul, {R C} and Screaton, {N J} and Wald, {N J} and D Weller and Williamson, {P R} and G Yadegarfar and Hansell, {D M}",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",

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doi = "10.1136/thoraxjnl-2015-207140",

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Field, JK, Duffy, SW, Baldwin, DR, Whynes, DK, Devaraj, A, Brain, KE, Eisen, T, Gosney, J, Green, BA, Holemans, JA, Kavanagh, T, Kerr, KM, Ledson, M, Lifford, KJ, McRonald, FE, Nair, A, Page, RD, Parmar, MKB, Rassl, DM, Rintoul, RC, Screaton, NJ, Wald, NJ, Weller, D, Williamson, PR, Yadegarfar, G & Hansell, DM 2016, 'UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening', Thorax, vol. 71, no. 2, pp. 161-170. https://doi.org/10.1136/thoraxjnl-2015-207140

TY - JOUR

T1 - UK Lung Cancer RCT Pilot Screening Trial

T2 - baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening

AU - Field, J K

AU - Duffy, S W

AU - Baldwin, D R

AU - Whynes, D K

AU - Devaraj, A

AU - Brain, K E

AU - Eisen, T

AU - Gosney, J

AU - Green, B A

AU - Holemans, J A

AU - Kavanagh, T

AU - Kerr, K M

AU - Ledson, M

AU - Lifford, K J

AU - McRonald, F E

AU - Nair, A

AU - Page, R D

AU - Parmar, M K B

AU - Rassl, D M

AU - Rintoul, R C

AU - Screaton, N J

AU - Wald, N J

AU - Weller, D

AU - Williamson, P R

AU - Yadegarfar, G

AU - Hansell, D M

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2016/2/1

Y1 - 2016/2/1

N2 - BACKGROUND: Lung cancer screening using low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial.METHODS: The 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.RESULTS: 247 354 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 mm(3) 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 mm(3) 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).CONCLUSIONS: The 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 REGISTRATION: ISRCTN 78513845.

AB - BACKGROUND: Lung cancer screening using low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial.METHODS: The 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.RESULTS: 247 354 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 mm(3) 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 mm(3) 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).CONCLUSIONS: The 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 REGISTRATION: ISRCTN 78513845.

U2 - 10.1136/thoraxjnl-2015-207140

DO - 10.1136/thoraxjnl-2015-207140

M3 - Article

C2 - 26645413

VL - 71

SP - 161

EP - 170

JO - Thorax

JF - Thorax

SN - 0040-6376

IS - 2

ER -

UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening

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