Baseline Results of the West London lung cancer screening pilot study - Impact of mobile scanners and dual risk model utilisation

被引：47

作者：

Bartlett, Emily C. ^{[1
]}

Kemp, Samuel, V ^{[2
,3
]}

Ridge, Carole A. ^{[1
]}

Desai, Sujal R. ^{[1
,3
]}

Mirsadraee, Saeed ^{[1
,3
]}

Morjaria, Jaymin B. ^{[4
]}

Shah, Pallav L. ^{[2
,3
]}

Popat, Sanjay ^{[3
,5
,6
]}

Nicholson, Andrew G. ^{[3
,7
]}

Rice, Alexandra J. ^{[7
]}

Jordan, Simon ^{[8
]}

Begum, Sofina ^{[8
]}

Mani, Aleksander ^{[8
]}

Derbyshire, Jane ^{[9
]}

Morris, Katie ^{[9
]}

Chen, Michelle ^{[9
]}

Peacock, Christine ^{[1
]}

Addis, James ^{[1
]}

Martins, Maria ^{[10
]}

Kaye, Stan B. ^{[11
]}

Padley, Simon P. G. ^{[1
,3
]}

Devaraj, Anand ^{[1
,3
]}

McDonald, Fiona

Robertus, Jan Lucas

Lim, Eric

Barnett, Joseph

Finch, Jonathan

Dalal, Paras

Yousaf, Nadia

Jamali, Armita

Ivashniova, Natallia

Phillips, Claudette

Newsom-Davies, Thomas

Lee, Richard

Vaghani, Pritti

Whiteside, Sarah

Vaughan-Smith, Stephen

机构：

[1] Royal Brompton & Harefield NHS Fdn Trust, Dept Radiol, Sydney St, London SW3 6NP, England

[2] Royal Brompton & Harefield NHS Fdn Trust, Dept Resp Med, Sydney St, London SW3 6NP, England

[3] Imperial Coll, Natl Heart & Lung Inst, London SW3 6LY, England

[4] Royal Brompton & Harefield NHS Fdn Trust, Harefield Hosp, Dept Resp Med, Hill End Rd, Harefield UB9 6JH, Middx, England

[5] Royal Marsden Hosp, Lung Unit, Fulham Rd, London SW6 3JJ, England

[6] Inst Canc Res, 123 Old Brompton Rd, London SW7 3RP, England

[7] Royal Brompton & Harefield NHS Fdn Trust, Dept Histopathol, Sydney St, London SW7 3RP, England

[8] Royal Brompton & Harefield NHS Fdn Trust, Dept Thorac Surg, Sydney St, London SW3 6NP, England

[9] West London Canc Alliance, RM Partners, 5th Floor,Alliance House,12 Caxton St, London SW1H 0QS, England

[10] Royal Brompton Hosp & Harefield NHS Fdn Trust, Resp Biomed Res Unit, Sydney St, London SW3 6NP, England

[11] Royal Marsden NHS Fdn Trust, RM Partners, Sycamore House,Downs Rd, Sutton SM2 5PT, Surrey, England

来源：

LUNG CANCER | 2020年 / 148卷

关键词：

Lung cancer screening; Uptake; Low dose CT; Risk prediction; Risk models; MANAGEMENT; SERVICE; TRIAL;

D O I：

10.1016/j.lungcan.2020.07.027

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: The West London lung screening pilot aimed to identify early-stage lung cancer by targeting low-dose CT (LDCT) to high risk participants. Successful implementation of screening requires maximising participant uptake and identifying those at highest risk. As well as reporting pre-specified baseline screening metrics, additional objectives were to 1) compare participant uptake between a mobile and hospital-based CT scanner and 2) evaluate the impact on cancer detection using two lung cancer risk models. Methods: From primary care records, ever-smokers aged 60-75 were invited to a lung health check at a hospital or mobile site. Participants with PLCOM2012 6-yr risk >= 1.51 % and/or LLPv2 5-yr risk >= 2.0 % were offered a LDCT. Lung cancer detection rate, stage, and recall rates are reported. Participant uptake was compared at both sites (chi-squared test). LDCT eligibility and cancer detection rate were compared between those recruited under each risk model. Results: Of 8366 potential participants invited, 1047/5135 (20.4 %) invitees responded to an invitation to the hospital site, and 702/3231 (21.7 %) to the mobile site (p = 0.14). The median distance travelled to the hospital site was less than to the mobile site (3.3 km vs 6.4 km, p < 0.01). Of 1159 participants eligible for a scan, 451/1159 (38.9 %) had a LLPv2 >= 2.0 % only, 71/1159 (6.1 %) had a PLCOM2012 >= 1.5 % only; 637/1159 (55.0 %) met both risk thresholds. Recall rate was 15.9 %. Lung cancer was detected in 29/1145 (2.5 %) participants scanned (stage 1, 58.6 %); 5/29 participants with lung cancer did not meet a PLCOM2012 threshold of >= 1.51 %; all had a LLPv2 >= 2.0 %. Conclusion: Targeted screening is effective in detecting early-stage lung cancer. Similar levels of participant uptake at a mobile and fixed site scanner were demonstrated, indicating that uptake was driven by factors in addition to scanner location. The LLPv2 model was more permissive; recruitment with PLCOM2012 alone would have missed several cancers.

引用

页码：12 / 19

页数：8

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