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UK lung cancer trial shows screening at-risk groups lowers mortality rates

Published: 14 September 2021

Results from the NIHR-funded UK Lung Screening Trial (UKLS), the first lung cancer computed tomography (CT) screening trial in the UK, have provided unequivocal support for lung cancer screening in identified high risk groups.

The findings have been presented at the 2021 IASLC World Lung Cancer Conference and published in the Lancet Regional Health Europe. They will also be presented to the UK National Screening Committee.

The UKLS study of single low dose computed tomography (LDCT) indicates a reduction of deaths from lung cancer of similar magnitude to major trials outside the UK, including the US National Lung Screening Trial (NLST) and the Dutch-Belgian NELSON trial.

During the trial, eligible groups aged 50 to 75 were assessed for risk of developing lung cancer over five years. From October 2011 to February 2013, 4,055 high risk participants were randomly allocated to either a single invitation to screening with LDCT or to no screening (usual care).

Data were collected on lung cancer cases and deaths to 29 February 2020 through linkage to national registries. The primary outcome was mortality due to lung cancer.

Participants were followed for approximately seven years, with 1,987 participants in the intervention and 1,981 in the usual care arms. In the LDCT arm, 86 cancers were diagnosed, compared to 75 in the control arm. Thirty lung cancer deaths were reported in the screening arm, and 46 in the group who received usual care. The benefit in terms of lung cancer mortality was seen most strikingly in 3 to 6 years after randomisation.

The researchers included results from nine randomised controlled trials, including the UKLS, in the meta-analysis, which indicated a significant reduction in lung cancer.

Lead researcher, Professor John Field, University of Liverpool said: “The UKLS mortality data and recent meta-analysis provides the impetus to now put in place a long-term lung cancer screening or lung health lung programme incorporating LDCT screening in the UK and also encourage nations in Europe to start their own programmes. Lung cancer early detection and surgical intervention saves lives.”

Professor Stephen Duffy, Queen Mary University and lead UKLS statistician said: "These results add to the international evidence that low dose CT screening reduces the risk of death from lung cancer. They also demonstrate that such screening can be made to work in the UK. Low dose CT can be added to the armoury of potential tools for the control of lung cancer."

This research was funded by the NIHR Health Technology Assessment Programme, the NIHR Policy Research Programme, and Roy Castle Lung Cancer Foundation.

The full study Lung cancer mortality reduction by LDCT screening: UKLS randomised trial results and international meta-analysis is available in the Lancet Regional Health Europe.

Please see the NIHR funding awards website to find out more about the project.

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