Screening scans ‘could cut lung cancer deaths’

Introducing lung screening for people at high risk of lung cancer could reduce deaths from the disease, according to new unpublished research.

A European study found the number of lung cancer deaths among men at high risk of lung cancer was 26% lower in those who had screening with a CT scan.

The first glimpse of the highly anticipated results suggested the benefits could be even greater in women. But experts said closer scrutiny of the data will be needed once it’s published.

The UK has no national lung screening programme, and the decision on whether to recommend a full population screening programme sits with the National Screening Committee.

It will need to review the latest results once they are published in full and consider how the harms and benefits of lung screening stack up, as well as the practicalities of introducing such a programme.

In anticipation of the full report, Cancer Research UK’s chief clinician, Professor Charlie Swanton, said that the findings could be “the news we’ve been waiting years for”.

CT lung screening

The research was presented by Dr Harry De Koning of the Erasmus Medical Center, Rotterdam at the World Conference on Lung Cancer (WCLC) in Toronto, Canada.

Over 15,000 people without lung cancer symptoms, but who had a history of heavy smoking, were included in the NELSON study. Half were offered four lung CT screenings during the study – one screening at the start followed by further scans at one, three and five-and-a-half years. No screening scans were offered to the other half of the participants and the number of deaths from lung cancer in each group were compared after a minimum of 10 years.

157 people died of lung cancer in the group who had CT screening, compared to 214 lung cancer deaths in the those who didn’t have screening.

De Koning said the results show CT lung screening scans are an effective way to not only find, but also assess, lung growths – called nodules – in people who’ve been invited for lung screening.

A release of the results reported that 7 out of 10 cancers (69%) detected through screening were found at the earliest stages (1A or 1B).

De Koning said that earlier detection of these cancers led to surgeries that “increase the chances of cure” and that the results “should be used to inform and direct future CT screening in the world”. 

Devastating impact

Swanton called the results “hugely exciting” and said the potential for lung screening to cut lung cancer deaths was “the news we’ve been waiting years for”.

“Now we need to see the full results published and considered as quickly as possible by the National Screening Committee,” he added.

The committee will be tasked with weighing up the harms and benefits of any potential lung screening programme, both in terms of costs and the impact it may have on people.

For example, it’s not yet clear the extent to which cancers may have been detected in the NELSON trial that would have otherwise never caused the patient any harm, a problem called overdiagnosis. This is just one factor to consider, with others including follow up tests that can cause harm or surgery to remove growths that may turn out not to be cancer.

Meanwhile, NHS England and certain research projects are continuing to test lung screening in studies.

In parts of England the NHS is running pilot projects where some high-risk people are being offered a lung health assessment, followed by a low dose CT scan.

Swanton said the ongoing and planned pilot studies “will help us learn as much possible about how we could make lung cancer screening work nationally”.

“I’ve seen the devastating impact of this disease first hand, with many of my patients diagnosed too late and not surviving more than a year. But these new findings give us hope that we can change the outlook for thousands of patients,” he added.