title: UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening.
abstract: BACKGROUND
  Lung cancer screening using low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial.
  
  
  METHODS
  The pilot UK Lung Cancer Screening (UKLS) is a randomised controlled trial of LDCT screening for lung cancer versus usual care. A population-based questionnaire was used to identify high-risk individuals. CT screen-detected nodules were managed by a pre-specified protocol. Cost effectiveness was modelled with reference to the National Lung Cancer Screening Trial mortality reduction.
  
  
  RESULTS
  247 354 individuals aged 50-75 years were approached; 30.7% expressed an interest, 8729 (11.5%) were eligible and 4055 were randomised, 2028 into the CT arm (1994 underwent a CT). Forty-two participants (2.1%) had confirmed lung cancer, 34 (1.7%) at baseline and 8 (0.4%) at the 12-month scan. 28/42 (66.7%) had stage I disease, 36/42 (85.7%) had stage I or II disease. 35/42 (83.3%) had surgical resection. 536 subjects had nodules greater than 50 mm(3) or 5 mm diameter and 41/536 were found to have lung cancer. One further cancer was detected by follow-up of nodules between 15 and 50 mm(3) at 12 months. The baseline estimate for the incremental cost-effectiveness ratio of once-only CT screening, under the UKLS protocol, was £8466 per quality adjusted life year gained (CI £5542 to £12 569).
  
  
  CONCLUSIONS
  The UKLS pilot trial demonstrated that it is possible to detect lung cancer at an early stage and deliver potentially curative treatment in over 80% of cases. Health economic analysis suggests that the intervention would be cost effective-this needs to be confirmed using data on observed lung cancer mortality reduction.
  
  
  BACKGROUND
  ISRCTN 78513845.
authors.affiliation: Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
authors.forename: J K
authors.initials: JK
authors.lastname: Field
authors.affiliation: Queen Mary University of London, London, UK.
authors.forename: S W
authors.initials: SW
authors.lastname: Duffy
authors.affiliation: Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: Baldwin
authors.affiliation: School of Economics, University of Nottingham, Nottingham, UK.
authors.forename: D K
authors.initials: DK
authors.lastname: Whynes
authors.affiliation: Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Devaraj
authors.affiliation: Cardiff University School of Medicine, Cardiff, UK.
authors.forename: K E
authors.initials: KE
authors.lastname: Brain
authors.affiliation: University of Cambridge, Cambridge Biomedical Research Centre, Cambridge, UK.
authors.forename: T
authors.initials: T
authors.lastname: Eisen
authors.affiliation: Department of Pathology, Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gosney
authors.affiliation: Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
authors.forename: B A
authors.initials: BA
authors.lastname: Green
authors.affiliation: Liverpool Heart and Chest Hospital, NHS Foundation Trust, Liverpool UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Holemans
authors.affiliation: Lung Cancer Patient Advocate, Liverpool, UK.
authors.forename: T
authors.initials: T
authors.lastname: Kavanagh
authors.affiliation: Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: K M
authors.initials: KM
authors.lastname: Kerr
authors.affiliation: Liverpool Heart and Chest Hospital, NHS Foundation Trust, Liverpool UK.
authors.forename: M
authors.initials: M
authors.lastname: Ledson
authors.affiliation: Cardiff University School of Medicine, Cardiff, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Lifford
authors.affiliation: Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
authors.forename: F E
authors.initials: FE
authors.lastname: McRonald
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Nair
authors.affiliation: Liverpool Heart and Chest Hospital, NHS Foundation Trust, Liverpool UK.
authors.forename: R D
authors.initials: RD
authors.lastname: Page
authors.affiliation: Medical Research Council Clinical Trials Unit at UCL, London, UK.
authors.forename: M K B
authors.initials: MK
authors.lastname: Parmar
authors.affiliation: Department of Histopathology, Papworth Hospital NHS Foundation Trust, Cambridge, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Rassl
authors.affiliation: Department of Histopathology, Papworth Hospital NHS Foundation Trust, Cambridge, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Rintoul
authors.affiliation: Department of Histopathology, Papworth Hospital NHS Foundation Trust, Cambridge, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Screaton
authors.affiliation: Queen Mary University of London, London, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Wald
authors.affiliation: Center for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: D
authors.initials: D
authors.lastname: Weller
authors.affiliation: Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
authors.forename: P R
authors.initials: PR
authors.lastname: Williamson
authors.affiliation: Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
authors.forename: G
authors.initials: G
authors.lastname: Yadegarfar
authors.affiliation: Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Hansell
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000379:methods*; D006113:United Kingdom / Q000453:epidemiology
keywords: Imaging/CT MRI etc; Lung Cancer