Consultant Respiratory Physician Professor of Primary Care Oncology Dr Mat Callister Prof. Richard Neal Consultant Respiratory Physician Professor of Primary Care Oncology St James’s University Hospital University of Leeds

Lung cancer survival vs GDP

Premature deaths in UK and Leeds Premature deaths in Leeds 2012-2014. www.healthierlives.phe.gov.uk

Community-ordered CXRs in Leeds 81% increase Leeds Early Lung Cancer Campaign

Early Stage Lung Cancer Leeds vs England Lung cancer survival England 1 YS 37% Leeds 1 YS 46% IELCAP 10 YS 80% Lung cancer survival England 1 YS 37% Leeds 1 YS 46%

CT screening for lung cancer Screening people at high risk of lung cancer with Low Dose CT (LDCT) reduces lung cancer deaths by 20%. LDCT screening is not currently offered by the NHS. The UK National Screening Committee is awaiting further evidence that screening is effective and deliverable in the UK before recommending a national programme.

Yorkshire Lung Screening Trial Funded by Yorkshire Cancer Research (£7m). Aims to invite approximately 30,000 people to a ‘Lung Health Check’ assessment – of which 7,000 expected to attend mobile vans in community locations. Lung Health Check involves clinical/demographic information, spirometry and screening CT scan. Control group of 30,000 people identified from GP datasets and followed for outcomes (but not consented – permission through HRA CAG).

What are the benefits to your practice taking part? Improved lung cancer outcomes for your patients. Spirometry will be measured for all patients and communicated to GPs for inclusion in GP datasets. All current smokers will be offered an immediate appointment with a smoking cessation practitioner in the van (with provision of NRT if requested). Each practice receives a one off payment of £250 to facilitate set-up.

What would be involved for your practice? Poster display prior to recruitment. On-site data extraction by research team (2 visits taking less than 30mins each) – one further visit at trial end (2023) for extraction of outcome data. Opportunity to review list of possible invitees. Trial team would need permission to use Practice headed paper and electronic GP signature. Prescribe Zyban/Champix for people who wish to quit using these drugs (if recommended by smoking cessation practitioner).

How have we attempted to minimise impact on General Practice? Central phone number for all queries about the study (invitation materials signpost this number). All scans reviewed by Radiologist and Respiratory Physician; where action in primary care needed, clear communication in concise letter. All referrals to Lung Cancer or any other LTH service arranged by trial team. All cases newly diagnosed COPD referred directly to the Community Respiratory Team.

What about people not invited? Targeting deprived practices with higher rates of smokers/ex-smokers and lung cancer. Patients identified from databases of participating practices randomised to invitation or control. Leaflets explaining the study, and the reasons why people might not have received an invite will be distributed to surgeries around the time of recruitment.

Timelines May 2018 – Finalise GP surgeries participating June 2018 – Dry run data extraction July 2018 onwards – Data extraction and invitation process September 2018 – August 2020 – Baseline screen September 2020 – August 2022 – 2nd round screen September 2022 – August 2023 – Final surveillance scans for nodules August 2024 – Study closes

Further information To participate or for further information please contact ylst@leeds.ac.uk Chief Investigator – Mat Callister (matthew.callister@nhs.net) Primary Care Lead – Richard Neal (R.D.Neal@leeds.ac.uk) Project Manager – Irene Simmonds (I.Simmonds@leeds.ac.uk)