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The UK Lung Screen (UKLS): demographic profile of first 88,897 approaches provides recommendations for population screening

McRonald, Fiona E., Yadegarfar, Ghasem, Baldwin, David R., Devaraj, Anand, Brain, Katherine, Eisen, Tim, Holemans, John A., Ledson, Martin, Screaton, Nicholas, Rintoul, Robert C., Hands, Christopher J., Lifford, Kate, Whynes, David, Kerr, Keith M., Page, Richard, Parmar, Mahesh, Wald, Nicholas, Weller, David, Williamson, Paula R., Myles, Jonathan, Hansell, David M., Duffy, Stephen W. and Field, John K. 2014. The UK Lung Screen (UKLS): demographic profile of first 88,897 approaches provides recommendations for population screening. Cancer Prevention Research 7 (3) , pp. 362-371. 10.1158/1940-6207.CAPR-13-0206

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Abstract

The UK Lung Cancer Screening trial (UKLS) aims to evaluate low-dose computed tomography (LDCT) lung cancer population screening in the United Kingdom. In UKLS, a large population sample ages 50 to 75 years is approached with a questionnaire to determine lung cancer risk. Those with an estimated risk of at least 5% of developing lung cancer in the next 5 years (using the Liverpool Lung project risk model) are invited to participate in the trial. Here, we present demographic, risk, and response rate data from the first 88,897 individuals approached. Of note, 23,794 individuals (26.8% of all approached) responded positively to the initial questionnaire; 12% of these were high risk. Higher socioeconomic status correlated positively with response, but inversely with risk (P < 0.001). The 50- to 55-year age group was least likely to participate, and at lowest cancer risk. Only 5% of clinic attendees were ages ≤60 years (compared with 47% of all 88,897 approached); this has implications for cost effectiveness. Among positive responders, there were more ex-smokers than expected from population figures (40% vs. 33%), and fewer current smokers (14% vs. 17.5%). Of note, 32.7% of current smokers and 18.4% of ex-smokers were designated as high risk. Overall, 1,452 of 23,794 positive responders (6.1%) were deemed high risk and attended a recruitment clinic. UKLS is the first LDCT population screening trial, selecting high-risk subjects using a validated individual risk prediction model. Key findings: (i) better recruitment from ex- rather than current smokers, (ii) few clinic attendees ages early 50s, and (iii) representative number of socioeconomically deprived people recruited, despite lower response rates.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Publisher: American Association for Cancer Research
ISSN: 1940-6207
Date of Acceptance: 9 December 2013
Last Modified: 25 Apr 2019 13:57
URI: http://orca.cf.ac.uk/id/eprint/79528

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