How Liverpool research paved way for UK lung cancer screening recommendation
Pioneering research in Liverpool, including at Liverpool Heart and Chest Hospital, has contributed to new government recommendations for a national lung cancer screening programme.
The UK National Screening Committee has recommended the introduction of targeted screening for 55 to 74-year-olds with a history of smoking who are at higher risk of lung cancer.
Lung cancer is Britain’s most common cause of cancer death, with smoking the most common cause. Although late-stage lung cancer has a poor prognosis, early-stage cancer can be successfully treated with a good clinical outcome if diagnosed early.
Over the past three decades, Liverpool has played an essential role in establishing the potential of lung cancer screening for early diagnosis in the UK.
In 1993, the Roy Castle Lung Cancer Foundation awarded a grant to Professor John Field to study genetic changes in lung cancer. This work formed the basis for the Liverpool Lung Project (LLP) and the development of the LLP risk model to help identify individuals at high risk of developing lung cancer.
Professor Field went on to lead the UK Lung Cancer Screening Trial (UKLS), the UK’s first lung cancer CT screening trial here at Liverpool Heart and Chest Hospital and also at Royal Papworth Hospital.
Results from the UKLS trial demonstrated the life-saving potential and financial feasibility of a programme of lung screening; prompting the UK’s first lung screening pilot in Liverpool, where there is a disproportionately high incidence of lung cancer.
Launched in 2016, the Liverpool Healthy Lung Project received an investment of £3m from the NHS Liverpool Clinical Commissioning Group (CCG) to tackle local health inequality.
Similar pilots followed in Manchester, Nottingham, London and Yorkshire, culminating in the introduction of the £70m NHS England lung screening programme in 2019. Since then, the programme has been delivering lung health-checks in over thirty localities utilising Liverpool’s risk model as a model for the identification of high-risk individuals.
The Liverpool Risk model and UKLS trial has attracted significant national and international recognition, including providing evidence for the European Position Statement on Lung cancer screening in Lancet Oncology (2017) and a major Nature Review on Lung cancer screening and future perspectives.
Professor John Field said: “Identification of early-stage lung cancer saves lives and Liverpool’s lung cancer risk-model has provided the UK with a clinically efficient, cost-effective method for targeted referral of high-risk individuals.
“The UKNSC recommendation now provides us with a pathway to implement lung cancer screening in the UK that will have a major impact on future patients.
“Data from our UKLS trial, implementation projects, together with the international trials NLST and NELSON, have provided the evidence needed to support this important UKNSC recommendation.”
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