LUNG cancer early diagnosis rates have soared during a targeted screening pilot in Manchester where on-the-spot CT scans were offered in shopping area car parks.
The results have sparked calls for the Manchester Lung Health Check pilot to be scaled up effectively to potentially save thousands of UK lives.
Eighty per cent of lung cancers diagnosed during the three-month pilot were discovered at the more curable ‘stage one and two’ as opposed to less than 20 per cent of patients diagnosed through usual pathways after reporting symptoms.
The pilot sited mobile low-dose CT scanners in three deprived areas of Manchester. It was funded by Macmillan Cancer Support through the Macmillan Cancer Improvement Partnership (MCIP). It was devised and implemented by University Hospital of South Manchester NHS Foundation Trust (UHSM) and MCIP in partnership with GPs, Manchester City Council, Macmillan and the three Manchester Clinical Commissioning Groups.
Data revealed by UHSM shows:
- 80 per cent of lung cancers diagnosed by the checks were discovered at the more curable ‘stage one and two’ as opposed to less than 20 per cent of patients diagnosed through usual pathways after reporting symptoms
- The percentage discovered at stage 4 reduced from nearly 50 per cent to just over ten per cent. Stage 4 lung cancer is almost always incurable and can result in rapid death
- More than 2500 people with a smoking history underwent the checks, with about half being offered an immediate CT scan which led to 42 cancers being discovered – that’s one lung cancer diagnosis on nearly every scanning day of the project
- Nearly 90 per cent of those diagnosed were offered curative treatment
- 20 per cent of attendees were diagnosed with COPD (chronic obstructive pulmonary disease)
Lung cancer is Manchester’s single biggest cause of premature death. Latest figures show it claimed the lives of 800 people aged under 75 over a two-year period. That’s 200 more than were Manchester has the highest premature mortality rates for lung cancer in England.
The results could pave the way for low-dose CT scanning in community settings to be used on a wider scale to reduce lung cancer mortality rates in what clinicians and Manchester’s health officials are describing as a ‘game changer’ for early diagnosis of the disease.
Dr Phil Barber, Consultant Respiratory Physician to the University Hospital of South Manchester and MCIP Clinical Lung Lead said: “The response from patients was extremely encouraging for future early diagnosis lung projects.
“It is often assumed that people living in more deprived areas like those chosen for this pilot do not usually take up screening opportunities but we have demonstrated that this is not the case, and that many people are keen to attend.
“We have hard evidence now that CT scanning high-risk patients helps us to identify cancers early enough to cure them, and we have also picked up many patients with other lung conditions at a much earlier stage than would otherwise have been possible.
‘’This is a landmark day for the respiratory health of Manchester people.“
Lynda Thomas, Chief Executive, Macmillan Cancer Support said: “Our Manchester pilot has achieved extraordinary success in diagnosing lung cancer at an early curative stage.
“Lung cancer is the most common cause of cancer death in the UK, claiming the lives of more than 35,000 people a year. Yet thousands of lives could be saved if early diagnosis screening of lung disease could be taken forward.
“The Macmillan Cancer Improvement Partnership in Manchester has found an approach that encourages people at high risk of lung disease to attend and undergo a highly effective diagnostic low-dose CT scan in a mobile unit in their own neighbourhood.
“People at high risk, often living in our most deprived areas, should be given this proven opportunity to improve their chances of surviving lung cancer and other lung diseases.”
Ian Williamson – Chief Accountable Officer (Designate), Manchester Health and Care Commissioning said: “From the outset we knew we had to do everything possible to help to reduce the number of deaths in Manchester from lung cancer.
“The lung health checks can not only help with this vital work, but they have also picked up signs of other breathing conditions like chronic obstructive pulmonary disease (COPD), where again, early detection is much better for patients.”
Lung Health Check patient, Michael Brady, who was diagnosed with stage one lung cancer after attending the LHC said: “I thought it was marvellous that we were being offered a Lung Health Check. As soon as I got my letter I called to make an appointment. It’s not every day that a CT scanner pulls up in your local car park. I’d have been mad not to take the opportunity.
“I’m having treatment now and I feel incredibly lucky that my lung cancer has been found at such an early and treatable stage.”
Watch Michael’s film here.
David Regan, Director of Public Health, Manchester City Council said: “The Lung Health Checks are a game-changer for outcomes in Manchester. We have high levels of deprivation and smoking that contribute significantly to our very high lung cancer rates.
“This pilot has engaged the most affected communities and offered new hope to many local people.”
Denis Colligan, Macmillan GP, North Manchester Clinical Commissioning Group said: “The engagement of Manchester’s GPs in this pilot has been pivotal to its success.
“GPs in Manchester are determined to change the outcomes of our patients. We have been working together with MCIP for the past three years to ensure that we could deliver this pilot successfully.
“My own practice in North Manchester was signed up to the pilot. We had clear information beforehand about was involved,
“Once the pilot started, the feedback from patients was very positive. The results have generated some extra work for us, but we can see the benefits in patients who have had an early diagnosis of lung cancer and subsequent treatment that has every chance of being curative.”
Professor Ashley Woodcock OBE, Professor of Respiratory Medicine at UHSM and The University of Manchester, said: “The pilot has been an enormous success. The important next steps are to learn the lessons in order to scale up effectively, and therefore ensure transferability to larger populations and to other regions.
“The Lung Health Check also identifies other lung and heart conditions, which require attention if we are to make a difference to population health. It is a unique “teachable moment”, an opportunity to link into stop smoking services, and to improve long term health.”
Janet Tonge, MCIP Programme Director said: “When we started work on the lung health checks we didn’t know if local people would want to use them or what they would find. So when cancers were found in the first few days of scanning it was an emotional moment for the MCIP team knowing we had enabled this ground-breaking service to happen and lives to be saved. That’s why I’m proud of having led the development of the lung check programme through the Macmillan Cancer Improvement Partnership.
Dr Richard Preece, Medical Director and Executive Lead for Quality, Greater Manchester Health and Social Care Partnership said: “I am immensely proud of this pioneering pilot undertaken with patients, local organisations and Macmillan to make a difference to people affected by lung cancer in Manchester. As the city’s biggest killer, it’s vital that we work together and act now to save lives.”
“We are committed to preventing cancer and detecting cancer early wherever we can and Devolution is changing how we do this. Building on our recent launch of a single cancer plan for the city-region, we hope to develop this pilot – the first of its kind in England – and expand our lung cancer screening programme for Greater Manchester.”
MCIP is sharing learning nationally on the pilot through the NHS England ACE Programme Wave 1 “Proactive lung cluster”.
Community leader and former Manchester Lord Mayor Paul Murphy with MCIP Lung Clinical Lead Dr Phil Barber, of UHSM