Nurse-led screening in GP practices boosts early lung cancer and COPD detection

A nurse-led screening programme in Liverpool is preventing around two cases of lung cancer a month across a dozen practices and driving up early detection of COPD, researchers have found.

Spirometry (Photo: Dr P Marazzi/Science Photo Library)
Spirometry (Photo: Dr P Marazzi/Science Photo Library)

The city's Healthy Lung Programme has organised clinics across practices in four areas of Liverpool, which has among the highest mortality rates for lung cancer in England and an estimated 6,000 people living with undiagnosed COPD.

Clinics run at local GP practices by specialist nurses from the city's hospitals invite patients aged 58-70 years old who have ever smoked and live in high-prevalence parts of the city for a lung assessment.

Patients found to be at high risk of developing lung cancer in the next five years - above a 5% threshold using a lung risk tool - are invited for a CT scan at a local hospital. Patients may also take a spirometry test, with abnormal results flagged up to their local GP for follow-up testing and management.

A total of 7,150 people across the four neighbourhoods covered by the scheme were invited in for screening within the programme's first year, and 45% have attended or booked to attend soon.

Cancer diagnosis

Three quarters of patients who received a lung cancer diagnosis through the programme received an early stage diagnosis, significantly improving their chances of succesful treatment and survival. Across Liverpool as a whole, 70% of diagnoses for lung cancer come at a late stage - stage 3 or 4.

Cancer Lead GP for Liverpool CCG Dr Ed Gaynor said findings from an independent evaluation by Queen Mary University of London and the University of Liverpool were 'extremely encouraging.

'They demonstrate how the Healthy Lung Programme is starting to make a measurable impact on people’s lung health by increasing early detection - and we are successfully doing this in communities which we know have some of the highest rates of lung cancer nationally.

'Through the programme we’ve also been trying to challenge some of the sense of fear and fatalism that exists towards cancer within these communities. Many of those we have been targeting through the programme say they feel scared to talk about cancer, so we have been sharing lots of survivor stories and working to educate more people about the benefits of early detection.'

A total of 19 lung cancers have been found at early, pre-symptomatic stage and treated, equivalent to to 1-2 cancers being prevented per month. Evaluation of the scheme also found it was cost effective, at around £4,000 per quality adjusted life year gained.

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