The UK Lung Screen (UKLS): demographic profile of first 88,897 approaches provides recommendations for population screening.
The UK Lung Cancer Screening trial (UKLS) aims to evaluate low-dose computed tomography (LDCT) lung cancer population screening in the United Kingdom. In UKLS, a large population sample ages 50 to 75 years is approached with a questionnaire to determine lung cancer risk. Those with an estimated risk of at least 5% of developing lung cancer in the next 5 years (using the Liverpool Lung project risk model) are invited to participate in the trial. Here, we present demographic, risk, and response rate data from the first 88,897 individuals approached. Of note, 23,794 individuals (26.8% of all approached) responded positively to the initial questionnaire; 12% of these were high risk. Higher socioeconomic status correlated positively with response, but inversely with risk (P < 0.001). The 50- to 55-year age group was least likely to participate, and at lowest cancer risk. Only 5% of clinic attendees were ages ≤60 years (compared with 47% of all 88,897 approached); this has implications for cost effectiveness. Among positive responders, there were more ex-smokers than expected from population figures (40% vs. 33%), and fewer current smokers (14% vs. 17.5%). Of note, 32.7% of current smokers and 18.4% of ex-smokers were designated as high risk. Overall, 1,452 of 23,794 positive responders (6.1%) were deemed high risk and attended a recruitment clinic. UKLS is the first LDCT population screening trial, selecting high-risk subjects using a validated individual risk prediction model.


RESULTS
(i) better recruitment from ex- rather than current smokers, (ii) few clinic attendees ages early 50s, and (iii) representative number of socioeconomically deprived people recruited, despite lower response rates.
Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, The University of Liverpool, Roy Castle Building, 200 London Road, Liverpool L3 9TA, United Kingdom. J.K.Field@liv.ac.uk.
Fiona E
FE
McRonald
Ghasem
G
Yadegarfar
David R
DR
Baldwin
Anand
A
Devaraj
Kate E
KE
Brain
Tim
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Eisen
John A
JA
Holemans
Martin
M
Ledson
Nicholas
N
Screaton
Robert C
RC
Rintoul
Christopher J
CJ
Hands
Kate
K
Lifford
David
D
Whynes
Keith M
KM
Kerr
Richard
R
Page
Mahesh
M
Parmar
Nicholas
N
Wald
David
D
Weller
Paula R
PR
Williamson
Jonathan
J
Myles
David M
DM
Hansell
Stephen W
SW
Duffy
John K
JK
Field
D000368:Aged; D055088:Early Detection of Cancer / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012923:Social Class; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology