Thousands of deaths from lung cancer in Scotland could be avoided if older current and former smokers were routinely screened for the disease, according to estimates due to be unveiled today at a cancer conference in Glasgow.
In September 2022, the UK National Screening Committee (NSC) recommended that all UK nations move towards developing targeted lung cancer screening programmes on the NHS for the first time for adults aged 55 to 74 who either smoke or used to smoke.
Under the scheme, those eligible would be invited for a risk assessment followed up by a low-dose CT scan to enable the earlier detection of tumours.
Lung checks are already running in parts of England with a timetable for a full national rollout by March 2030, but there are currently no confirmed plans for an equivalent initiative in Scotland.
Lung cancer remains the leading cause of cancer deaths in Scotland, claiming around 4000 lives every year.
Of the 5000 cases diagnosed annually, 3,300 people are picked up at stages three or four when it is harder to treat.
Analysis by Cancer Research UK estimates that at least 2,300 lung cancer deaths could be avoided over the coming decade if just 50% of eligible adults took part in screening.
The modelling - based on previous research - also forecasts that around 400 extra cases per year could be diagnosed at stages one or two, instead of stages three or four, if screening were introduced.
The charity said the figures highlight the "urgent need" for a national targeted lung cancer screening programme as part of the Scottish Government’s 10-year cancer strategy, which aims to halve the percentage of total cancer cases diagnosed at a late stage from 42% to 24% by 2033.
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Michelle Mitchell, Cancer Research UK's chief executive, will put the case to Health Secretary Michael Matheson when he attends the Scottish Cancer Conference in Glasgow today.
Ms Mitchell said: “Lung cancer is a tragedy for Scotland. More people die of lung cancer in Scotland than any other type of cancer.
"It is devastating for families and hits those who live in Scotland’s poorest communities very hard.
“A comprehensive commitment by the Scottish Government to implement a fully-funded national targeted lung cancer screening programme is a real chance to reduce the toll of lung cancer on Scots.
“Lung screening matters because it means more people can be diagnosed at an earlier stage, when treatment is more likely to be successful.
“There have been big improvements in how we diagnose and treat other forms of cancer, but long-term lung cancer survival in the UK isn’t much higher than it was 50 years ago.
“This is unacceptable when evidence shows that earlier diagnosis through targeted lung cancer screening can potentially help thousands of people live longer healthier lives.”
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One of the biggest obstacles to implementation is delivering the extra staff and scanning resources needed to manage a surge in demand for screening.
The latest data from Public Health Scotland shows that the number of people on waiting lists for a CT scan has already climbed from 14,921 in March 2019 to 23,252 as of June this year, without routine lung checks.
The number of people waiting more than 13 weeks for a CT scan has also soared over the same period from 85 to 3,075, although this is down from a peak of more than 7,400 in May 2022.
Annual lung cancer incidence in Scotland is projected to grow by 10% by the end of the next decade, due to the effects of an ageing population.
Professor David Weller, co-head of Edinburgh University's Centre for Population Health Sciences, will also attend today's conference to report on the progress of the Scottish Government-funded pilot study, LungScot, which has been inviting patients in NHS Lothian for lung screening.
The project will be extended over the coming months to residents in the Grampian, Greater Glasgow and Clyde, and Highlands and Islands regions to help inform the implementation of a national screening programme in Scotland.
Professor Weller said: “For too long, lung cancer has been perceived as a disease you can’t do anything about, but we know that diagnosis at an early stage really can make a difference.
“Major trials of targeted lung cancer screening show significant reductions in mortality from lung cancer. Pilot studies in the UK and internationally consistently show people being diagnosed with lung cancer at an earlier stage.
“If a nation-wide screening programme was introduced, it has the potential to be a game changer when it comes to reducing the burden of lung cancer in Scotland.”
A spokesman for the Scottish Government said: “We welcome the recommendation from the UK NSC for all four UK nations to move forward with introducing targeted screening for lung cancer in adults aged 55-74 with a history of smoking.
"We note that the UK NSC also acknowledges the significant complexities that must be worked through ahead of implementation.
“We have established a Scottish Expert Advisory Group, in collaboration with National Screening Oversight (NSO), which will consider how the recommendation can best be taken forward.
"Furthermore we have agreed further funding of a one year extension of the University of Edinburgh’s feasibility study, LungScot, into targeted lung health checks for high risk individuals.”
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