People aged 55-74 with history of smoking to be offered lung cancer screening

People in England aged 55-74 who smoke, or who have previously smoked, and are identified as high risk will be offered lung cancer screening, the government has announced.

People in England aged 55-74 who smoke, or who have previously smoked, and are identified as high risk will be offered lung cancer screening, the government has announced.

The UK NSC recommends inviting people aged 55-74 who either smoke, or used to smoke, to an initial assessment. This is because smoking is the leading cause of lung cancer and is responsible for more than 7 in 10 cases in the UK. This is different to the current cancer screening programmes in the UK, which invite people based on just their age or gender.

The initial assessment will involve a health professional asking some questions to determine if someone is at a high risk of lung cancer. If they are, they will then be offered a low dose CT scan of the lungs.

A low dose CT scan helps to check for changes in the lungs that may be lung cancer. The scan uses x-rays and a computer to create detailed pictures of the lungs from different angles to form a 3D image.

A type of specialist doctor called a radiologist examines the scan and if it shows anything abnormal, the person may be invited for further tests. If somebody has suspected lung cancer, they will be referred so it can be diagnosed as soon as possible. If other abnormalities are found, they may be invited to screening more regularly. By screening people at high risk, we can find lung cancers earlier and save more lives from the disease.

Why is lung cancer screening not recommended for everyone?

We know that current cancer screening tests offered on the NHS save thousands of lives each year. But screening isn’t perfect and has harms as well as benefits.

All screening programmes must target groups of people where the benefits outweigh the harms. This is why current cancer screening programmes are only offered to certain age groups. Targeted lung screening will take this further, by inviting only those who are at a higher risk of developing cancer based on other factors – in this case smoking status.

Studies show that lung cancer screening reduces lung cancer deaths in people with a history of smoking. However, people who have never smoked are at a much smaller risk of lung cancer, so it’s unlikely that they would benefit from screening in the same way.

There are also harms associated with lung screening. These include exposure to small amounts of radiation from the test itself, false positives (where a potential cancer is incorrectly found and leads to unnecessary follow-up procedures) and false negatives (where the test misses a cancer).

Some people may also be diagnosed with a cancer that would never have gone on to cause harm in their lifetime. In other words, if the person hadn’t been tested, they might never have known they had cancer. This is known as overdiagnosis.

So targeting lung screening at people who smoke, or used to smoke, can maximise the balance of the benefits and harms of screening.

by Emma Bower

Source https://www.gponline.com/

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