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1. BRCA-DIRECT digital pathway for diagnostic germline genetic testing within a UK breast oncology setting: a randomised, non-inferiority trial

Author

Torr, Bethany, Jones, Christopher, Kavanaugh, Grace, Hamill, Monica, Allen, Sophie, Choi, Subin, Garrett, Alice, Valganon-Petrizan, Mikel, MacMahon, Suzanne, Yuan, Lina, Way, Rosalind, Harder, Helena, Gold, Rochelle, Taylor, Amy, Gabe, Rhian, Lucassen, Anneke, Manchanda, Ranjit, Fallowfield, Lesley, Jenkins, Valerie, Gandhi, Ashu, Evans, D. Gareth, George, Angela, Hubank, Michael, Kemp, Zoe, Bremner, Stephen, and Turnbull, Clare

Published
2024
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3. Prospective Evaluation of Lung Cancer Screening Eligibility Criteria and Lung Cancer Detection in the Yorkshire Lung Screening Trial

Author

Gabe, Rhian, Crosbie, Philip A.J., Vulkan, Daniel, Bailey, Hannah, Baldwin, David R., Bradley, Claire, Booton, Richard, Darby, Michael J., Eckert, Claire, Hancock, Neil, Hinde, Sebastian, Janes, Sam M., Kennedy, Martyn P.T., Marshall, Catriona, Moller, Henrik, Murray, Rachael L., Neal, Richard D., Quaife, Samantha L., Rogerson, Suzanne, Shinkins, Bethany, Simmonds, Irene, Upperton, Sara, and Callister, Matthew E.J.

Published
2024
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7. Lung cancer mortality reduction by LDCT screening: UKLS randomised trial results and international meta-analysis

Author

Field, John K., Vulkan, Daniel, Davies, Michael P.A., Baldwin, David R., Brain, Kate E., Devaraj, Anand, Eisen, Tim, Gosney, John, Green, Beverley A., Holemans, John A., Kavanagh, Terry, Kerr, Keith M., Ledson, Martin, Lifford, Kate J., McRonald, Fiona E., Nair, Arjun, Page, Richard D., Parmar, Mahesh K.B., Rassl, Doris M., Rintoul, Robert C., Screaton, Nicholas J., Wald, Nicholas J., Weller, David, Whynes, David K., Williamson, Paula R., Yadegarfar, Gasham, Gabe, Rhian, and Duffy, Stephen W.

Published
2021
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10. 165 Can Pathway Navigation increase lung cancer screening uptake? Protocol for a nested randomised controlled trial and process evaluation

Author

McInnerney, Daisy, primary, Simmonds, Irene, additional, Hancock, Neil, additional, Rogerson, Suzanne, additional, Lindop, Jason, additional, Gabe, Rhian, additional, Vulkan, Daniel, additional, Marshall, Catriona, additional, Crosbie, Philip AJ, additional, Callister, Matthew EJ, additional, and Quaife, Samantha L, additional

Published
2024
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12. Personalized Antihypertensive Treatment Optimization With Smartphone‐Enabled Remote Precision Dosing of Amlodipine During the COVID‐19 Pandemic (PERSONAL‐CovidBP Trial)

Author

Collier, David J., primary, Taylor, Mike, additional, Godec, Thomas, additional, Shiel, Julian, additional, James, Rebecca, additional, Chowdury, Yasmin, additional, Ebano, Patrizia, additional, Monk, Vivienne, additional, Patel, Mital, additional, Pheby, Jane, additional, Pheby, Ruby, additional, Foubister, Amanda, additional, David, Clovel, additional, Saxena, Manish, additional, Richardson, Leanne, additional, Siddle, James, additional, Timlin, Gregor, additional, Goldsmith, Paul, additional, Deeming, Nicholas, additional, Poulter, Neil R., additional, Gabe, Rhian, additional, McManus, Richard J., additional, and Caulfield, Mark J., additional

Published
2024
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14. Aspirin versus placebo for the treatment of venous leg ulcers—a phase II, pilot, randomised trial (AVURT)

Author

Tilbrook Helen, Cook Liz, Clark Laura, Sbizzera Illary, Bland Martin, Buckley Hannah, Chetter Ian, Dumville Jo, Fenner Chris, Forsythe Rachael, Gabe Rhian, Harding Keith, Layton Alison, Lindsay Ellie, Mc Daid Catriona, Moffatt Christine, Rolfe Debbie, Stansby Gerard, Torgerson David, Vowden Peter, Williams Laurie, and Hinchliffe Robert

Subjects
Trial, Pilot, Randomised, Aspirin, Placebo, Venous, Medicine (General), R5-920
Abstract

Abstract Background Venous leg ulcers (VLUs) can take many months to heal and 25% fail to heal. The main treatment for venous leg ulcers is compression therapy and few additional therapies exist. Two previous trials indicated that low-dose aspirin may improve healing time, but these trials were insufficiently robust. Methods A multi-centred, pilot, phase II, randomised, double blind, parallel-group, placebo-controlled, efficacy trial (RCT) was conducted to determine: if aspirin improves VLU healing time; the safety of aspirin in this population; treatment compliance; and the feasibility of recruitment to a phase III trial. We recruited patients from secondary care who were aged ≥ 18 years, had a chronic VLU and not regularly taking aspirin. Participants were randomly assigned (1:1) to receive 300 mg of daily aspirin or placebo in addition to standard care, which consisted of multi component compression therapy aiming to deliver 40 mmHg at the ankle where possible. The randomisation list was stratified by ulcer size (≤ 5 cm2 or > 5 cm2). The primary endpoint was time to ulcer healing, which was defined as ‘complete epithelial healing in the absence of scab (eschar) with no dressing required’. Safety outcomes were assessed in all participants who received at least one dose of the study drug. Results Twenty-seven patients were recruited from eight sites (target 100 patients). A short time-frame to recruit and a large number of patients failing to meet the eligibility criteria were the main barriers to recruitment. There was no evidence of a difference in time to healing of the reference ulcer following adjustment for log ulcer area and duration (hazard ratio 0.58, 95% confidence interval 0.18 to 1.85; p = 0.357). One expected serious adverse event related to aspirin was recorded. A number of options to improve recruitment were explored. Conclusions There was no evidence that aspirin was effective in expediting the healing of chronic VLUs. However, the analysis was underpowered due to the low number of participants recruited. The trial design would require substantial amendment in order to progress to a phase III (effectiveness) trial. Trial registration Clinicaltrials.gov, NCT02333123. Registered on 5 November 2014.

Published
2019
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17. The radiology quality assurance process in the Yorkshire Lung Screening Trial, and findings from the baseline round of low dose CT screening for lung cancer

Author

Upperton, Sara E C, primary, Bradley, Claire, additional, Bhartia, Bobby S K, additional, Crosbie, Philip A J, additional, Darby, Michael, additional, Gabe, Rhian, additional, Hammond, Christopher, additional, Hancock, Neil, additional, Marshall, Catriona, additional, Kennedy, Martyn P T, additional, and Callister, Matthew, additional

Published
2023
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20. Computed Tomography Cardiac Angiography Before Invasive Coronary Angiography in Patients With Previous Bypass Surgery: The BYPASS-CTCA Trial

Author

Jones, Daniel A., primary, Beirne, Anne-Marie, additional, Kelham, Matthew, additional, Rathod, Krishnaraj S., additional, Andiapen, Mervyn, additional, Wynne, Lucinda, additional, Godec, Thomas, additional, Forooghi, Nasim, additional, Ramaseshan, Rohini, additional, Moon, James C., additional, Davies, Ceri, additional, Bourantas, Christos V., additional, Baumbach, Andreas, additional, Manisty, Charlotte, additional, Wragg, Andrew, additional, Ahluwalia, Amrita, additional, Pugliese, Francesca, additional, Mathur, Anthony, additional, Bourantas, Christos, additional, Timmis, Adam, additional, Rees, Paul, additional, Patel, Riyaz, additional, Gupta, Ajay, additional, Treibel, Thomas, additional, Guttmann, Oliver, additional, Choudry, Fizzah, additional, Gabe, Rhian, additional, Richards, Amy, additional, Saberwal, Bunny, additional, Kavanagh, Zara, additional, Champion, Nicola, additional, Hall, Russell, additional, Benford, Marian, additional, Chowdhury, Shahana, additional, Hammond, Victoria, additional, Menezes, Simon, additional, Cheasty, Emma, additional, Balan, Anu, additional, Menezes, Leon, additional, Castle, Emily, additional, Yap-Sanderson, Joanna, additional, Sinha, Apurva, additional, Vickers, Joanne, additional, McCarthy, Carmel, additional, Hamshere, Steve, additional, Comer, Katrina, additional, Egan, Katherine, additional, Sooriyamohan, Mohanakumar, additional, Tsiatsani, Maria, additional, and Hall, Rob, additional

Published
2023
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23. Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial

Author

Upperton, Sara, primary, Beirne, Paul, additional, Bhartia, Bobby, additional, Boland, Alison, additional, Bradley, Claire, additional, Crosbie, Philip A J, additional, Darby, Mike, additional, Eckert, Claire, additional, Gabe, Rhian, additional, Hancock, Neil, additional, Kennedy, Martyn P T, additional, Lindop, Jason, additional, Rogerson, Suzanne, additional, Shinkins, Bethany, additional, Simmonds, Irene, additional, Sutherland, Tim J T, additional, and Callister, Matthew E J, additional

Published
2023
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24. Measuring spirometry in a lung cancer screening cohort highlights possible underdiagnosis and misdiagnosis of COPD

Author

Bradley, Claire, primary, Alexandris, Panos, additional, Baldwin, David R., additional, Booton, Richard, additional, Darby, Mike, additional, Eckert, Claire J., additional, Gabe, Rhian, additional, Hancock, Neil, additional, Janes, Sam, additional, Kennedy, Martyn, additional, Lindop, Jason, additional, Neal, Richard D., additional, Rogerson, Suzanne, additional, Shinkins, Bethany, additional, Simmonds, Irene, additional, Upperton, Sara, additional, Vestbo, Jorgen, additional, Crosbie, Philip A.J., additional, and Callister, Matthew E.J., additional

Published
2023
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25. An evaluation of CT radiation doses within the Yorkshire Lung Screening Trial.

Author

Iball, Gareth R, Beeching, Charlotte E, Gabe, Rhian, Tam, Hui Zhen, Darby, Michael, Crosbie, Philip A J, and Callister, Matthew E J

Subjects
LUNGS, RADIATION doses, CONE beam computed tomography, MEDIAN (Mathematics), COMPUTED tomography, DISEASE risk factors
Abstract

Objectives To evaluate radiation doses for all low-dose CT scans performed during the first year of a lung screening trial. Methods For all lung screening scans that were performed using a CT protocol that delivered image quality meeting the RSNA QIBA criteria, radiation dose metrics, participant height, weight, gender, and age were recorded. Values of volume CT dose index (CTDIvol) and dose length product (DLP) were evaluated as a function of weight in order to assess the performance of the scan protocol across the participant cohort. Calculated effective doses were used to establish the additional lifetime attributable cancer risks arising from trial scans. Results Median values of CTDIvol, DLP, and effective dose (IQR) from the 3521 scans were 1.1 mGy (0.70), 42.4 mGycm (24.9), and 1.15 mSv (0.67), whilst for 60-80kg participants the values were 1.0 mGy (0.30), 35.8 mGycm (11.4), and 0.97 mSv (0.31). A statistically significant correlation between CTDIvol and weight was identified for males (r  = 0.9123, P  < .001) and females (r  = 0.9052, P  < .001), however, the effect of gender on CTDIvol was not statistically significant (P  = .2328) despite notable differences existing at the extremes of the weight range. The additional lifetime attributable cancer risks from a single scan were in the range 0.001%-0.006%. Conclusions Low radiation doses can be achieved across a typical lung screening cohort using scan protocols that have been shown to deliver high levels of image quality. The observed dose levels may be considered as typical values for lung screening scans on similar types of scanners for an equivalent participant cohort. Advances in knowledge Presentation of typical radiation dose levels for CT lung screening examinations in a large UK trial. Effective radiation doses can be of the order of 1 mSv for standard sized participants. Lifetime attributable cancer risks resulting from a single low-dose CT scan did not exceed 0.006%. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Protocol for a Prospective Study Evaluating Circulating Tumour Cells Status to Predict Radical ProstatectomyTreatment Failure in Localised Prostate Cancer Patients (C- ProMeta-1)

Author

Al-Hammouri, Tarek, primary, Almeida-Magana, Ricardo, additional, Lawrence, Rachel, additional, Duffy, Tom, additional, White, Laura, additional, Burke, Edwina, additional, Kudahetti, Sakunthala, additional, Collins, Justin, additional, Rajan, Prabhakar, additional, Berney, Daniel, additional, Gabe, Rhian, additional, Shaw, Greg, additional, and Lu, Yong-Jie, additional

Published
2023
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27. The impact of reminder invitations on participation in community-based lung cancer screening

Author

Bailey, Hannah, primary, Alexandris, Panos, additional, Bradley, Claire, additional, Eckert, Claire, additional, Gabe, Rhian, additional, Hancock, Neil, additional, Kennedy, Martyn, additional, Lindop, Jason, additional, Marshall, Catriona, additional, Quaife, Samantha, additional, Rogerson, Suzanne, additional, Simmonds, Irene, additional, Upperton, Sara, additional, Crosbie, Philip, additional, and Callister, Matthew, additional

Published
2023
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28. The effectiveness of offering ongoing and repeated provision of co-located, opt-out smoking cessation support as part of a lung cancer screening programme

Author

Murray, Rachael, primary, Thorley, Rebecca, additional, Baldwin, David, additional, Copeland, Harriet, additional, Lewis, Sarah, additional, Crosbie, Philip, additional, Quaife, Samantha, additional, Brain, Kate, additional, McCutchan, Grace, additional, Rogerson, Suzanne, additional, Gabe, Rhian, additional, and Callister, Matthew, additional

Published
2023
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31. Diagnosis and treatment outcomes from prebronchodilator spirometry performed alongside lung cancer screening in a Lung Health Check programme

Author

Bradley, Claire, primary, Boland, Alison, additional, Clarke, Louisa, additional, Dallinson, Naomi, additional, Eckert, Claire, additional, Ellames, Deborah, additional, Finn, Jonathan, additional, Gabe, Rhian, additional, Hancock, Neil, additional, Kennedy, Martyn PT, additional, Lindop, Jason, additional, Mohamed, Ayad, additional, Mullen, Gabriel, additional, Murray, Rachael L, additional, Rogerson, Suzanne, additional, Shinkins, Bethany, additional, Simmonds, Irene, additional, Upperton, Sara, additional, Wilkinson, Anne, additional, Crosbie, Philip A, additional, and Callister, Matthew EJ, additional

Published
2023
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32. Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK

Author

Oxley, Samuel, primary, Kalra, Ashwin, additional, Sideris, Michail, additional, Itzkowitz, Nicole, additional, Evans, Olivia, additional, Atakpa, Emma Christine, additional, Brentnall, Adam R., additional, Dworschak, Nina, additional, Gaba, Faiza, additional, Gabe, Rhian, additional, Sundar, Sudha, additional, Wood, Nick, additional, Nicum, Shibani, additional, Taylor, Alexandra, additional, Dobbs, Stephen, additional, McCluggage, W. Glenn, additional, Nordin, Andy, additional, Legood, Rosa, additional, Kehoe, Sean, additional, Ghaem-Maghami, Sadaf, additional, and Manchanda, Ranjit, additional

Published
2023
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35. Participation in community-based lung cancer screening: the Yorkshire Lung Screening Trial

Author

Crosbie, Philip A.J., Gabe, Rhian, Simmonds, Irene, Hancock, Neil, Alexandris, Panos, Kennedy, Martyn, Rogerson, Suzanne, Baldwin, David, Booton, Richard, Bradley, Claire, Darby, Mike, Eckert, Claire, Franks, Kevin N., Lindop, Jason, Janes, Sam M., Murray, Rachael L., Neal, Richard D., Quaife, Samantha L., Upperton, Sara, Shinkins, Bethany, Tharmanathan, Puvan, and Callister, Matthew E. J.

Subjects
Pulmonary and Respiratory Medicine
Abstract

Question Screening with low dose computed tomography (LDCT) reduces lung-cancer mortality; however, the most effective strategy for optimising participation is unknown. Here we present data from the Yorkshire Lung Screening Trial, including response to invitation, screening eligibility and uptake of community-based LDCT screening.Methods Individuals aged 55 to 80, identified from primary care records as having ever smoked, were randomised prior to consent to invitation to telephone lung cancer risk assessment or usual care. The invitation strategy included General Practitioner endorsement, pre-invitation and two reminder invitations. After telephone triage, those at higher risk were invited to a Lung Health Check (LHC) with immediate access to a mobile CT scanner.Results Of 44 943 individuals invited, 50.8% (n=22 815) responded and underwent telephone-based risk assessment (16.7% and 7.3% following first and second reminders respectively). A lower response rate was associated with current smoking status (adjOR 0.44, 95%CI 0.42–0.46) and socio-economic deprivation (adjOR 0.58, 95% CI 0.54–0.62 most versus least deprived quintile). Of those responding, 34.4% (n=7853) were potentially eligible for screening and offered a LHC, of whom 86.8% (n=6819) attended. Lower uptake was associated with current smoking status (adjOR 0.73, 95%CI 0.62–0.87) and socio-economic deprivation (adjOR 0.78, 95% CI 0.62–0.98). In total 6,650 individuals had a baseline LDCT scan, representing 99.7% of eligible LHC attendees.Conclusion Telephone risk assessment followed by a community-based LHC is an effective strategy for lung cancer screening implementation. However, lower participation associated with current smoking status and socio-economic deprivation underlines the importance of research to ensure equitable access to screening.

Published
2022

37. Cost-utility of cytisine for smoking cessation over and above behavioural support in people with newly diagnosed pulmonary tuberculosis: an economic evaluation of a multicentre randomised controlled trial

Author

Li, Jinshuo, primary, Parrott, Steve, additional, Keding, Ada, additional, Dogar, Omara, additional, Gabe, Rhian, additional, Marshall, Anna-Marie, additional, Huque, Rumana, additional, Barua, Deepa, additional, Fatima, Razia, additional, Khan, Amina, additional, Zahid, Raana, additional, Mansoor, Sonia, additional, Kotz, Daniel, additional, Boeckmann, Melanie, additional, Elsey, Helen, additional, Kralikova, Eva, additional, Readshaw, Anne, additional, Sheikh, Aziz, additional, and Siddiqi, Kamran, additional

Published
2022
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38. A digital pathway for genetic testing in UK NHS patients with cancer: BRCA-DIRECT randomised study internal pilot

Author

Torr, Bethany, primary, Jones, Christopher, additional, Choi, Subin, additional, Allen, Sophie, additional, Kavanaugh, Grace, additional, Hamill, Monica, additional, Garrett, Alice, additional, MacMahon, Suzanne, additional, Loong, Lucy, additional, Reay, Alistair, additional, Yuan, Lina, additional, Valganon Petrizan, Mikel, additional, Monson, Kathryn, additional, Perry, Nicky, additional, Fallowfield, Lesley, additional, Jenkins, Valerie, additional, Gold, Rochelle, additional, Taylor, Amy, additional, Gabe, Rhian, additional, Wiggins, Jennifer, additional, Lucassen, Anneke, additional, Manchanda, Ranjit, additional, Gandhi, Ashu, additional, George, Angela, additional, Hubank, Michael, additional, Kemp, Zoe, additional, Evans, D Gareth, additional, Bremner, Stephen, additional, and Turnbull, Clare, additional

Published
2022
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39. Diagnostic accuracy of magnetic resonance imaging targeted biopsy techniques compared to transrectal ultrasound guided biopsy of the prostate: a systematic review and meta-analysis

Author

Bass, Edward J., Bass, Edward J., Pantović, Ana, Connor, Martin J., Loeb, Stacy, Rastinehad, Ardeshir R., Winkler, Mathias H., Gabe, Rhian, Ahmed, Hashim U., Bass, Edward J., Bass, Edward J., Pantović, Ana, Connor, Martin J., Loeb, Stacy, Rastinehad, Ardeshir R., Winkler, Mathias H., Gabe, Rhian, and Ahmed, Hashim U.

Abstract

Background: Multiparametric MRI localizes cancer in the prostate, allowing for MRI guided biopsy (MRI-GB) 43 alongside transrectal ultrasound-guided systematic biopsy (TRUS-GB). Three MRI-GB approaches exist; visual estimation (COG-TB); fusion software-assisted (FUS-TB) and MRI ‘in-bore’ biopsy (IB-TB). It is unknown whether any of these are superior. We conducted a systematic review and meta-analysis to address three questions. First, whether MRI-GB is superior to TRUS-GB at detecting clinically significant PCa (csPCa). Second, whether MRI-GB is superior to TRUS-GB at avoiding detection of insignificant PCa. Third, whether any MRI-GB strategy is superior at detecting csPCa. Methods: A systematic literature review from 2015 to 2019 was performed in accordance with the START recommendations. Studies reporting PCa detection rates, employing MRI-GB and TRUS-GB were included and evaluated using the QUADAS-2 checklist. 1553 studies were found, of which 43 were included in the meta-analysis. Results: For csPCa, MRI-GB was superior in detection to TRUS-GB (0.83 vs. 0.63 [p = 0.02]). MRI-GB was superior in detection to TRUS-GB at avoiding detection of insignificant PCa. No MRI-GB technique was superior at detecting csPCa (IB-TB 0.87; COG TB 0.81; FUS-TB 0.81, [p = 0.55]). There was significant heterogeneity observed between the included studies. Conclusions: In patients with suspected PCa on MRI, MRI-GB offers superior rates of csPCa detection and reduces detection of insignificant PCa compared to TRUS-GB. No individual MRI-GB technique was found to be better in csPCa detection. Prospective adequately powered randomized controlled trials are required.

Published
2022

41. sj-docx-1-msc-10.1177_09691413221117685 - Supplemental material for The prevalence of comorbidity in the lung cancer screening population: A systematic review and meta-analysis

Author

Almatrafi, Anas, Thomas, Owen, Callister, Matthew, Gabe, Rhian, Beeken, Rebecca J, and Neal, Richard

Subjects
111708 Health and Community Services, FOS: Clinical medicine, 111402 Obstetrics and Gynaecology, FOS: Health sciences
Abstract

Supplemental material, sj-docx-1-msc-10.1177_09691413221117685 for The prevalence of comorbidity in the lung cancer screening population: A systematic review and meta-analysis by Anas Almatrafi, Owen Thomas, Matthew Callister, Rhian Gabe, Rebecca J Beeken and Richard Neal in Journal of Medical Screening

Published
2022
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42. sj-docx-2-msc-10.1177_09691413221117685 - Supplemental material for The prevalence of comorbidity in the lung cancer screening population: A systematic review and meta-analysis

Author

Almatrafi, Anas, Thomas, Owen, Callister, Matthew, Gabe, Rhian, Beeken, Rebecca J, and Neal, Richard

Subjects
111708 Health and Community Services, FOS: Clinical medicine, 111402 Obstetrics and Gynaecology, FOS: Health sciences
Abstract

Supplemental material, sj-docx-2-msc-10.1177_09691413221117685 for The prevalence of comorbidity in the lung cancer screening population: A systematic review and meta-analysis by Anas Almatrafi, Owen Thomas, Matthew Callister, Rhian Gabe, Rebecca J Beeken and Richard Neal in Journal of Medical Screening

Published
2022
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43. Effect of Collaborative Care vs Usual Care on Depressive Symptoms in Older Adults With Subthreshold Depression: The CASPER Randomized Clinical Trial

Author

Gilbody, Simon, Lewis, Helen, Adamson, Joy, Atherton, Katie, Bailey, Della, Birtwistle, Jacqueline, Bosanquet, Katharine, Clare, Emily, Delgadillo, Jaime, Ekers, David, Foster, Deborah, Gabe, Rhian, Gascoyne, Samantha, Haley, Lesley, Hamilton, Jahnese, Hargate, Rebecca, Hewitt, Catherine, Holmes, John, Keding, Ada, Lilley-Kelly, Amanda, Meer, Shaista, Mitchell, Natasha, Overend, Karen, Pasterfield, Madeline, Pervin, Jodi, Richards, David A., Spilsbury, Karen, Traviss-Turner, Gemma, Trépel, Dominic, Woodhouse, Rebecca, Ziegler, Friederike, and McMillan, Dean

Published
2017
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45. Impact of frailty and comorbidity on initial response to lung cancer screening invitation and low-dose CT screening uptake: Findings from the Yorkshire Lung Screening Trial.

Author

Almatrafi, Anas, Gabe, Rhian, Beeken, Rebecca J, Neal, Richard D, Clegg, Andrew, Best, Kate E, Relton, Samuel, Brown, Martel, Tam, Hui Zhen, Hancock, Neil, Crosbie, Philip A.J., and Callister, Matthew E.J.

Subjects
*DISEASE risk factors, *COMPUTED tomography, *COMORBIDITY, *EARLY detection of cancer, *MEDICAL screening
Abstract

Low-dose computed tomography screening reduces lung cancer-specific mortality in high-risk individuals. Lung cancer risk factors overlap with comorbid diseases, highlighting the significance of frailty and comorbidities for lung cancer screening (LCS). Here, we describe the prevalence of frailty and comorbidity in those invited for LCS and evaluate their associations with response to telephone risk assessment invitation and subsequent uptake of LCS.Analysis was based on the intervention arm of the Yorkshire Lung Screening Trial, where ever-smoked individuals aged 55–80 were invited to telephone risk assessment followed by community-based LCS if at higher risk. The electronic frailty index (eFI) was used to compute individual frailty scores (categorised as fit, mild, moderate and severe) and derive comorbidity data.Of 27,761 individuals invited, 24.1% (n = 6702), 8.5% (n = 2353) and 1.7% (n = 459) had mild, moderate and severe frailty, respectively. Over half responded to the invitation to telephone risk assessment (n = 14,523, 52.5%) with frailty associated with a higher response rate compared to fit individuals: adjusted odds ratio (ORadj) 1.34, 95% confidence interval (CI) 1.26–1.42 for mild frailty; ORadj 1.28, 95%CI 1.16–1.40 for moderate frailty; and ORadj 1.32, 95%CI 1.08–1.61 for severe frailty. Similar patterns were seen with comorbidity counts. After assessment, moderate (ORadj 0.75, 95%CI 0.59–0.96) and severe (ORadj 0.67, 95%CI 0.43–1.04) frailty were associated with reduced screening uptake.The presence of frailty was associated with increased response to LCS invitation. Given the strong association between frailty and reduced life expectancy, these results suggest that people with potentially more life years to be gained from LCS may be less inclined to take part. Further research is needed to explore the interactions between frailty and LCS decision-making to inform future invitation strategies. [ABSTRACT FROM AUTHOR]

Published
2025
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46. Therapeutic Targeting of Integrin αvβ6 in Breast Cancer

Author

Moore, Kate M., Thomas, Gareth J., Duffy, Stephen W., Warwick, Jane, Gabe, Rhian, Chou, Patrick, Ellis, Ian O., Green, Andrew R., Haider, Syed, Brouilette, Kellie, Saha, Antonio, Vallath, Sabari, Bowen, Rebecca, Chelala, Claude, Eccles, Diana, Tapper, William J., Thompson, Alastair M., Quinlan, Phillip, Jordan, Lee, Gillett, Cheryl, Brentnall, Adam, Violette, Shelia, Weinreb, Paul H., Kendrew, Jane, Barry, Simon T., Hart, Ian R., Jones, J. Louise, and Marshall, John F.

Published
2014
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48. WHOSE DOSE IS IT ANYWAY? INDIVIDUAL PATIENT DOSE-RESPONSE CURVES FROM THE REMOTE-CARE PERSONAL-COVIDBP TRIAL

Author

Taylor, Mike, primary, Godec, Tom, additional, Shiel, Julian, additional, James, Rebecca, additional, Chowdury, Yasmin, additional, Ebano, Patrizia, additional, Monk, Vivienne, additional, Patel, Mital, additional, Pheby, Jane, additional, Enobakhare, Enamuna, additional, Foubister, Amanda, additional, David, Clovell, additional, Saxena, Manish, additional, Siddle, James, additional, Timlin, Gregor, additional, Goldsmith, Paul, additional, Deeming, Nick, additional, Poulter, Neil R., additional, Gabe, Rhian, additional, McManus, Richard, additional, and Collier, David J., additional

Published
2022
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49. Results from the randomised UKLS trial: Lung cancer mortality reduction by LDCT screening confirmed in an international meta-analysis

Author

Field, John K., Vulkan, Daniel, Davies, Micahel P.A., Baldwin, David R., Brain, Kate E., Devaraj, Anand, Eisen, Tim, Holemans, John A., Kavanagh, Terry, Kerr, Keith M., Ledson, Martin, Lifford, Kate J., McRonald, Fiona E., Nair, Arjun, Page, Richard D., Parmar, Mahesk K.B., Rassi, Doris M., Rintoul, Robert C., Wald, Nicolas J., Weler, David, Whynes, David K., Williamson, Paul R., Yadegarfar, Casham, Gabe, Rhian, and Duffy, Stephen W.

Abstract

Background\ud \ud The NLST reported a significant 20% reduction in lung cancer mortality with three annual low-dose CT (LDCT) screens and the Dutch-Belgian NELSON trial indicates a similar reduction. We present the results of the UKLS trial.\ud Methods\ud \ud From October 2011 to February 2013, we randomly allocated 4 055 participants to either a single invitation to screening with LDCT or to no screening (usual care). Eligible participants (aged 50–75) had a risk score (LLPv2) ≥ 4.5% of developing lung cancer over five years. Data were collected on lung cancer cases to 31 December 2019 and deaths to 29 February 2020 through linkage to national registries. The primary outcome was mortality due to lung cancer. We included our results in a random-effects meta-analysis to provide a synthesis of the latest randomised trial evidence.\ud Findings\ud \ud 1 987 participants in the intervention and 1 981 in the usual care arms were followed for a median of 7.3 years (IQR 7.1–7.6), 86 cancers were diagnosed in the LDCT arm and 75 in the control arm. 30 lung cancer deaths were reported in the screening arm, 46 in the control arm, (relative rate 0.65 [95% CI 0.41–1.02]; p=0.062). The meta-analysis indicated a significant reduction in lung cancer mortality with a pooled overall relative rate of 0.84 (95% CI 0.76–0.92) from nine eligible trials.\ud Interpretation\ud \ud The UKLS trial of single LDCT indicates a reduction of lung cancer death of similar magnitude to the NELSON and NLST trials and was included in a meta-analysis of nine randomised trials which provides unequivocal support for lung cancer screening in identified risk groups.\ud Funding\ud \ud NIHR Health Technology Assessment programme; NIHR Policy Research programme; Roy Castle Lung Cancer Foundation.\ud Keywords\ud Lung Cancer\ud CT Screening\ud Lung Cancer Mortality\ud Meta-analysis

Published
2021

50. The prevalence of comorbidity in the lung cancer screening population: A systematic review and meta-analysis.

Author

Almatrafi, Anas, Thomas, Owen, Callister, Matthew, Gabe, Rhian, Beeken, Rebecca J, and Neal, Richard

Subjects
CINAHL database, META-analysis, MEDICAL information storage & retrieval systems, FRAIL elderly, SYSTEMATIC reviews, LUNG tumors, EARLY detection of cancer, MEDICAL protocols, DISEASE prevalence, MEDLINE, COMPUTED tomography, COMORBIDITY
Abstract

Objective: Comorbidity is associated with adverse outcomes for all lung cancer patients, but its burden is less understood in the context of screening. This review synthesises the prevalence of comorbidities among lung cancer screening (LCS) candidates and summarises the clinical recommendations for screening comorbid individuals. Methods: We searched MEDLINE, EMBASE, EBM Reviews, and CINAHL databases from January 1990 to February 2021. We included LCS studies that reported a prevalence of comorbidity, as a prevalence of a particular condition, or as a summary score. We also summarised LCS clinical guidelines that addressed comorbidity or frailty for LCS as a secondary objective for this review. Meta-analysis was used with inverse-variance weights obtained from a random-effects model to estimate the prevalence of selected comorbidities. Results: We included 69 studies in the review; seven reported comorbidity summary scores, two reported performance status, 48 reported individual comorbidities, and 12 were clinical guideline papers. The meta-analysis of individual comorbidities resulted in an estimated prevalence of 35.2% for hypertension, 23.5% for history of chronic obstructive pulmonary disease (COPD) (10.7% for severe COPD), 16.6% for ischaemic heart disease (IHD), 13.1% for peripheral vascular disease (PVD), 12.9% for asthma, 12.5% for diabetes, 4.5% for bronchiectasis, 2.2% for stroke, and 0.5% for pulmonary fibrosis. Conclusions: Comorbidities were highly prevalent in LCS populations and likely to be more prevalent than in other cancer screening programmes. Further research on the burden of comorbid disease and its impact on screening uptake and outcomes is needed. Identifying individuals with frailty and comorbidities who might not benefit from screening should become a priority in LCS research. [ABSTRACT FROM AUTHOR]

Published
2023
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