Cancer screening has helped to improve survival rates for breast, bowel, and cervical cancer – and we think it could do the same for lung cancer. In this blog, we look at why Yorkshire needs lung cancer screening, how it could work in practice, and the difference it could make.
Why is lung cancer a problem in Yorkshire?
Lung cancer is the leading cause of cancer death in Yorkshire, with about 3,000 people living in the region dying from the disease every year.
As a charity, our goal is that at least 2,000 more people survive cancer each year. Given that almost 1 in 4 of all deaths from cancer in our region are because of lung cancer, it’s crucial that we try and tackle the poor survival rates from the disease.
One of the main reasons few people survive lung cancer is that it is often diagnosed too late. In Yorkshire, more than 7 out of 10 lung cancers are diagnosed at a late stage (stage 3 or 4), when it becomes more difficult to treat successfully.
However, diagnosing it earlier is not simple. Unlike other types of cancers, lung cancer doesn’t always cause symptoms at an early stage. Even when the cancer is more advanced, the most common symptoms, such as a persistent cough, are sometimes dismissed or attributed to other less serious illnesses.
To stop people dying from lung cancer, we need a way to pick up tumours at an earlier stage. And this is exactly what cancer screening programmes are designed for.
What difference could lung cancer screening make?
Cancer screening involves testing specific groups of healthy people who are at the highest risk of developing cancer. It can detect cancer at an early stage, before symptoms develop. Some types of screening, for example cervical and bowel, can also prevent cancer from developing by finding early changes to cells and allowing them to be treated.
Across the UK we already have national screening programmes for breast, bowel, and cervical cancer. These programmes have helped to significantly improve survival rates for these cancers. We believe that having a lung cancer screening programme for those at risk of the disease would be transformative, and help increase the numbers of people surviving.
And the lung cancer community agrees. The UK Lung Cancer Coalition – an alliance of healthcare professionals, industry, patient groups, and charities including Yorkshire Cancer Research – says that the “the roll-out of a full lung cancer screening programme across all four nations will do more to improve lung cancer survival than any other intervention.”
Finding lung cancer when it is in an early stage and not yet causing symptoms improves survival. When lung cancer is diagnosed at the earliest possible stage (stage 1) around 6 in 10 people will survive for 5 years or more.
How does lung cancer screening work?
Lung cancer screening is carried out using a low-dose CT scan of the chest. This is a type of scan where the person lies on a platform which is moved inside the hole of a doughnut-shaped machine. CT scanners use X-rays to take images from multiple angles to create a 3D picture of the body.
There have been several trials of lung cancer screening across the world. For example, a US trial invited people at risk of lung cancer to have low-dose CT scans once a year for three years. The results showed that screening reduced the risk of dying from lung cancer by 20% during the five years after the trial, compared to a standard chest X-ray. Now in the USA, people who currently or previously smoked aged 50 to 80 years are advised to attend annual lung screening.
Across England, the Liverpool Healthy Lung Programme, Manchester’s Lung Health Check (LHC) pilot and the UK Lung Screening Trial (UKLS) have found 76-85% of lung cancers at Stage I or II using low dose CT scans. Currently in Yorkshire only around 30% of lung cancers are diagnosed at an early stage.
What is Yorkshire Cancer Research doing about lung cancer screening?
The Leeds Lung Health Check, funded by Yorkshire Cancer Research, is one of the largest lung screening trials in the UK. CT scans are offered to people at the highest risk of lung cancer: people between the ages of 55 and 80 who currently or previously smoked.
The Lung Health Check is like a free MOT for the lungs, offering a range of tests to make sure the lungs are working as they should. This includes a low-dose CT scan so that doctors can spot any early signs of lung cancer. People who currently smoke are also provided with 1-to-1 stop smoking advice and ongoing support. All these elements take place during the same appointment, in a mobile scanning van at convenient locations like supermarket car parks.
The researchers running the trial are developing a template of 'best practice' that could be rolled out across the UK, providing the evidence needed to introduce a lung screening programme.
Three years after it was launched in November 2018, Leeds Lung Health Check is delivering promising results. According to the latest figures from October 2021, 6,650 people in Leeds have received at least one CT scan. As a result, more than 180 cancers have been diagnosed, most of which were picked up at an early stage when the disease is more treatable.
What needs to happen to make sure everyone can get lung cancer screening?
The UK’s National Screening Committee – the body which advises the government and the NHS on screening programmes – decided in 2007 that there wasn’t yet enough evidence to recommend that the UK have a lung cancer screening programme. However, the National Screening Committee is due to review this decision soon, and we believe that there is more than enough evidence now.
Political leadership and action are also required to make sure that the NHS has the workforce it needs to effectively deliver a national lung screening programme. This can be achieved through a multi-year investment in the cancer workforce, something we have been calling on the Government to commit to.
Our message is clear: a national lung cancer screening programme would help to cut the number of deaths from this disease, and help more people in our region live longer and healthier lives.
Learn more about the Leeds Lung Health Check, funded by Yorkshire Cancer Research.