Lung cancer screening programme could be "game changer" for treatment

Screenings are due to start across the South West in 2022

If a screening programme is approved nationally we're told it would be one of the biggest changes in lung cancer treatment ever
Author: James DiamondPublished 16th Nov 2021
Last updated 16th Nov 2021

Potential new screenings for lung cancer would represent a complete game changer for treatment, we've been told.

The comment from a South West doctor comes amid a new NHS England Targeted Lung Health Checks (TLHC) programme , which next year will see people across our region invited for checks.

The initiative, being supported by artificial intelligence, is the first large-scale lung cancer screening programme to be run in the UK and is looking to detect around 3,400 cancers.

It is hoped it could save hundreds of lives by 2025.

Nineteen pilot lung checks have been rolled out so far across the country – 15 of which using lung nodule management solutions provided by Aidence – are expected to generate 200,000 scans by 2024.

Veye Lung Nodules, the Aidence-designed AI solution, automatically detects, measures, classifies, and tracks the growth of pulmonary nodules on chest CT scans – all laborious and time-consuming tasks for clinicians when performed manually.

Doctor Graham Robinson is a radiology consultant at Royal United Hospital in Bath and president of the British Society of Thoracic Imaging.

"Sadly lung cancer has a high mortality (rate)," he said.

"It is the third most common cancer in the UK and the second most common cancer in males.

"It effects around 40 to 50,000 people a year and currently there is no signed off screening programme for this."

The TLHCs have been running in different places for several years as a pilot, with the hope it will become an official national screening programme in the near future.

In our area schemes have recently been approved across Somerset, Wiltshire, Avon and Gloucestershire as well as Devon and Cornwall.

If the programme was approved as a national initiative long term, Dr Robinson says it would be a "game changer" for treatment.

"It would be one of the biggest changes in lung cancer management and diagnosis ever really," he said.

"unfortunately the symptoms of lung cancer can present late and therefore there are a number of patients that have a late diagnosis and their prognosis is less good.

"However if you pick up lung cancer early there is definitely the ability to treat and cure these cancers so, this is a game changer for lung cancer."

When the scheme begins in our area, people who have ever smoked will be invited by their GP for a lung health check.

Statistically, around half of them will be deemed at higher risk of lung cancer and be invited for a CT scan, at which point the imaging will be examined by radiologists with the help of AI.

"The AI actually helps the radiologist, who is reporting a lot of these scans, find these potential lung nodules, which are the early signs of a lung cancer, they'll find them, they'll give the size, they'll give the volume of that lung nodule and on the basis of that technology you'll then decide whether that patient needs further management, or actually the scans are reassuring sufficiently to go to the next round of screening, or whether they need a surveillance scan in three months," Dr Robinson said.

The ambition is for pilot screenings to begin by April 2022 in the South West.

We asked Dr Robinson why screenings for lung cancer don't already exist.

"The mainstay if you had a cough or you went to your GP with some chest symptoms, the main investigation is usually a chest X-ray," he said.

"There have been many studies over the years on whether chest x-ray sufficiently meets the criteria for a screening programme and unfortunately it wasn't shown to save lives fundamentally.

"We've known that CT scanning produces exquisite imaging of the lungs read by the radiologists, but historically it has been a technology issue really.

"The CT scanners do impart a radiation dose to the patient and at a screening level by definition these are asymptomatic patients.

"A few years ago the CT scanning technology perhaps delivered a dose that people were nervous about, but this now is using low dose CT scanning."

There have already been large screening studies in Europe and the USA, so Dr Robinson says it has already been proven that such scans can save lives.

Instead, Dr Robinson says the pilot is largely to test out how a screening programme would smoothly integrate into the NHS system.

"I think it will become a signed off programme," he said.

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