The EU Position Statement on Lung Cancer Screening (EUPS) has been published in Lancet Oncology. It presents the available evidence and the major issues that need to be addressed by policymakers to ensure lung screening programmes are successful - with a strong recommendation that Europe must start planning for implementation within the next 18 months.
‘Patients with a high risk of developing lung cancer can be identified with early stage disease have a significant chance of surviving for five years or more.’
The EUPS has been developed by Professor John Field at the University of Liverpool, UK and Professor Matthijs Oudkerk at the University of Groningen, Netherlands together with 20 clinical specialists in lung cancer screening throughout Europe, including Austria, Denmark, Germany, Italy, Spain, Netherlands, Poland and the UK.
The EUPS provides a detailed set of recommendations as to how Europe can successfully implement lung cancer screening and a hard hitting 'Call to Action' for planning to start now for implementation over the next 18 months - with the ambition to start lung cancer screening afterwards.
Issues highlighted across Europe include a need for investment in static and mobile CT scanner units, the need to recruit and train sufficient radiologists, and a plan for how to identify and invite high risk individuals for screening.
Lung cancer causes 1.6 million deaths each year worldwide representing almost one-fifth of all cancer deaths. Within the EU, lung cancer is responsible for almost 270,000 annual deaths.
However, if a patient's lung cancer is identified at an early stage, then their outcome is greatly improved. The UK Lung Cancer Screening Trial (UKLS), led by Professor Field at the University of Liverpool, reported in 2016 that patients with a high risk of developing lung cancer can be identified with early stage disease, who can be treated with surgery, have a significant chance of surviving for five years or more.
Results from the US National Lung Cancer Screening Trial (NLST) on reduced lung cancer mortality and from seven pilot screening trials within Europe (including the UKLS) provide "sufficient evidence for Europe to start planning for lung cancer screening", the statement says.
Corresponding author, Professor John Field, Clinical Professor of Molecular Oncology, University of Liverpool said: "Quite simply, lung cancer screening saves lives. There is now a consensus opinion across Europe that we should start to plan for the implementation of lung cancer CT screening immediately.
"Following the publication of the UKLS trial data the Liverpool Clinical Commissioning Group (CCG) have made a major investment into the Liverpool Healthy Lung Programme and have successfully identified individuals from the hard to reach communities and offered them Lung CT scans, identifying early stage disease with a very high proportion suitable for surgical intervention. Similar early detection lung cancer demonstration studies are currently underway in Manchester, London and Nottingham, with plans for Yorkshire next year."
Professor Field added: "While there are a number of early detection demonstration studies offering screening to high-risk patients currently underway across the UK, these are all time-limited due to their funding. We should be laying the foundations now for a comprehensive long term lung cancer CT screening programme and undertake the required planning within the next 18 months."
Professor Matthijs Oudkerk, Medical Scientific Director at the Center for Medical Imaging, University of Groningen said: "The EUPS provides Europe with a detailed 18 month time line in which to implement lung cancer screening that will have an enormous impact on the disease."
"The EUPS recommends the introduction of forefront radiological lung cancer volumetric biomarkers together with precision medicine management approaches to be applied to lung cancer screening, which will minimise the harms and have a positive impact on decreasing lung cancer mortality."