Scientists outline new guidelines for future of lung cancer screening

A University scientist has led an international workshop to define future approaches to lung cancer screening programmes.

The International Association for the Study of Lung Cancer (IASLC) Task Force, chaired by Professor John Field from the University’s Cancer Research Centre, has identified six areas of research to further progress investigations into the feasibility of lung cancer screening programmes at hospitals around the world.

The IASLC Strategic CT Screening Advisory Committee (SSAAC) will focus on research into high risk individuals for lung cancer and developing radiological guidelines for use in future national CT screening programmes. Work will include strategy for the clinical work-up of ‘indeterminate nodules’ resulting from lung cancer CT screening and outlines for pathology reporting of nodules from screening programmes. Researchers are also drawing up recommendations for surgical and therapeutic interventions of possible cancerous nodules and integration of smoking cessation practices into future screening trials.

The work builds on the completion of the National Lung Screening Trial in the US, which found that lung cancer deaths fell by 20 percent when smokers were screened annually for three years using low-dose spiral computed tomography (LDCT) compared to standard chest x-ray.

Members of the IASLC group are engaging with international professional societies and organisations that are stakeholders in lung cancer CT, to assemble information about best practice that may be used by different countries to suit their specific health care systems.

The IASLC study will help inform the pilot UK Lung Screening (UKLS) trial, launched by Liverpool scientists earlier this year. UKLS will assess the expertise and technology at the pilot sites in cancer centres in the UK, which could efficiently support a large-scale screening programme, like systems already in place for breast cancer detection.

The UKLS study follows the completion of Liverpool-led research to identify the risk factors of developing lung cancer, which includes history of respiratory disease and smoking.

Professor Field said: “Data from the National Lung Screening Trial in the US provided the first evidence that low-dose spiral computed tomography for lung cancer screening can save lives and is, therefore, the most encouraging data we have had on the international stage with respect this disease for many years.

“It is essential that we look at ongoing international trials, such as this one, to provide further information on outstanding issues before considering the implementation of national CT screening programmes around the world.”

Findings from the IASLC team on the future of lung cancer screening is published in the Journal of Thoracic Oncology.

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