Lung cancer survival rate increases by 73% if caught early

A major lung cancer screening trial, conducted by experts at the University of Liverpool, has found

that patients Liverpool Article Lungwith a high risk of

developing lung cancer can be identified

with early stage disease and have up to a

73% chance of surviving five years or

more.

The UK Lung Cancer Screening Trial

(UKLS) was undertaken in partnership

with Liverpool Heart & Chest

Hospital, Papworth Hospital and the Royal Brampton & Harefield Hospital with the aim of

highlighting the need for a screening programme to help benefit people who are at risk of developing

lung cancer.

The Chief Investigator of the UKLS trial is Progessor Jogn Field, who is based in the University’s

Institute of Translational Medicine.

Identifying those at risk

Lung cancer kills more people than any other cancer. The number of deaths in 2012 in the UK

was 35,370, making lung cancer the commonest cause of cancer death in the UK for both

men and women.

The main reasons why lung cancer outcomes are so poor, are that approximately 70% of

patients first present to specialist care with incurable advanced disease and current

treatment at this late stage has very little effect on mortality.

However, if a patient’s lung cancer is identified at an early stage, then the clinical outcome is

greatly improved. Individuals with very early stage disease have up to a 73% chance of

surviving for five years or more and over 80% have had surgical interventions. As a result

there is a major national and international focus on CT screening trials.

National screening programme

The results of the UKLS trial provide further evidence for the UK National Screening

Committee (UKNSC) to consider when making a decision whether to implement a national

screening programme in the UK in the future.

Funded by the NIHR Health Technology Assessment Programme the trial was the first and

only lung cancer screening trial to take place in the UK and has provided in depth information

on how to set up a national lung cancer CT screening programme, including using a risk

prediction model to identify high risk individuals in the population.

State-of-the-art approach

UKLS is a randomised controlled trial of lung cancer screening versus usual care in 4055

individuals that used a population-based questionnaire to identify high-risk individuals. The

screening, used a low dose of an imaging procedure that uses special x-ray equipment to

create detailed pictures, or scans, of areas inside the body called Low Dose Computed

tomography (LDCT).

In the USA’s National Lung Cancer Screening Trial, LDCT was shown to reduce lung cancer

mortality by 20%. The UKLS screening trial also used a ‘state of the art approach’ to identify

very early lung cancer nodules.

The UKLS trial has received full ethical approval and has been funded by the NIHR Health

Technology Assessment programme and the results have been published in full in the HTA

Publications today.

Health economic analysis also suggests that the screening intervention could be cost effective

-this needs to be confirmed using data on observed lung cancer mortality reduction

Improving survival rates

Professor John Field, Clinical Professor of Molecular Oncology and the Chief Investigator of the

UKLS trial, said: “The UKLS trial has successfully demonstrated that we have a way to screen

for lung cancer in high risk individuals in the UK.

“However, as UKLS was a pilot trial, researchers are currently awaiting the outcome of the

Dutch CT screening trial, which will potentially provide mortality data to argue for

implementation of a national lung cancer screening programme in the UK.

“If we could detect lung cancer via screening of high risk individuals, it would make a major

impact on the diagnosis of lung cancer at an earlier stage of the disease and would greatly

improve the survival rates of those affected by this terrible disease.”