The Yorkshire Lung Screening Trial, a randomised controlled trial of low dose computed tomography (CT) screening conducted in Leeds, has found that a telephone risk assessment followed by a community-based Lung Health Check with immediate access to a mobile CT scanner is an effective screening strategy, but participation appears to be lower among current smokers and the socio-economically deprived.
Low dose CT screening is known to reduce lung cancer mortality, but the most effective strategy to optimise screening participation is unknown. In this study, people aged 55-80 who had ever smoked were randomised to either invitation to telephone lung cancer risk assessment, or usual care. The invitation strategy included GP endorsement, pre-invitation, and two reminder invitations. Of 44943 subjects invited, 22815 underwent telephone triage; 7853 subjects who were identified as being at higher risk were offered a Lung Health Check, which 6819 attended. Lower uptake rates for both the invitation to telephone triage and the Health Check were observed for current smokers and among the socio-economically deprived, and non-attendance increased with age. Authors note that the encouraging response to invitation observed in this trial was considerably higher than recently reported participation rates in the US. This may relate to the invitation strategies, including the use of a second reminder letter, which appeared to augment the response rate by 7%.
WIPH author Rhian Gabe said: “It is great that participation in our Lung Health Checks has been successful by international standards, however, we urgently need to address participation barriers in these populations to maximise the lives saved by lung cancer screening and ensure equitable access to services for those most at risk of lung cancer.”
Participation in community-based lung cancer screening: the Yorkshire Lung Screening Trial. Crosbie PAJ, Gabe R, Simmonds I, Hancock N, Alexandris P, Kennedy M, Rogerson S, Baldwin D, Booton R, Bradley C, Darby M, Eckert C, Franks KN, Lindop J, Janes SM, Møller H, Murray RL, Neal RD, Quaife SL, Upperton S, Shinkins B, Tharmanathan P, Callister MEJ. Eur Respir J 2022 Jul 1:2200483. doi: 10.1183/13993003.00483-2022