Lung cancer can be spotted earlier and diagnosed more precisely with the help of a blood test, a major study carried out in Scotland has found.

 

The Early Detection of Cancer of the Lung Scotland (ECLS) is the world’s largest clinical biomarker trial looking into detecting early lung cancer using a blood test. It was led by the University of Dundee in collaboration with the University of Glasgow, with further work from the Universities of Aberdeen, St Andrews, Nottingham and Toronto, NHS Scotland, Scottish Government, The Canberra Hospital and Oncimmune, the company that developed the new blood test. Tayside Clinical Trials Unit was responsible for trial delivery, data management and analysis.

The study looked at over 12,000 people in Scotland who volunteered to be part of the study. Adults aged 50 to 75 who had a high risk of developing lung cancer over the next 24 months were eligible to participate, and participants were recruited in the NHS areas of Tayside, Greater Glasgow and Clyde, and Lanarkshire.

The EarlyCDT®-Lung Test, followed by low-dose CT imaging for those who test positive, was found to identify 32% of lung cancers which occurred, with a high specificity of 90%.

Professor Frank Sullivan, co-chief investigator of the study, said, “This study moves us closer to making an earlier diagnosis of lung cancer, which could have a significant impact in saving lives.

“Lung cancer has been notoriously difficult to spot early and to treat. Scanning produces a lot of `false positive’ results, which then place demand on resources as they are followed up and investigated.

“The blood test, followed by imaging may be better at identifying those people who actually have cancer.  This could reduce by about two-thirds the amount of imaging needed to determine whether someone at high risk actually has lung cancer.

“The question we need to answer next is whether a combination of blood testing and imaging can offer a real step-change in lung cancer diagnosis.”

Patients in the study who had a positive result from the text were offered a chest X-ray followed by a CT scan. If the initial CT scan revealed no evidence of lung cancer then subsequent CT scans were offered six-monthly for 24 months.

There were cases where lung cancer was identified early due to people having volunteered for the study, and they were subsequently referred for clinical care as appropriate. 

The University of Glasgow recruited and followed over 9,000 patients for this study.  Lead researcher there, Professor Frances Mair, said, “The findings of this study offer a viable and positive way forward for earlier diagnosis and treatment of lung cancer.  This has the potential to be of huge benefit to patients, although whether this should be used for screening or case finding will require further investigation.”

Scotland has one of the highest rates of lung cancer in the world; 2592 men and 2739 women were diagnosed with lung cancer in Scotland in 2017. In that year 4069 people with lung cancer in Scotland died.

In the UK, survival from lung cancer is poor with less than 9% of patients still alive at five years after diagnosis, due primarily to the late stage of presentation. In around 80% of cases the cancer has spread beyond the lungs by the time it is diagnosed. If the disease is diagnosed in the early stages cure rates can be 60-70%.

The Early Detection of Cancer of the Lung Scotland (ECLS) trial has shown that using a blood test to detect lung cancer earlier can significantly reduce late-stage presentation of the disease, allowing for earlier treatment and this is likely to reduce mortality rates

Funding for the study was provided by the Scottish Government, Chief Scientist Office and Oncimmune.

Enquiries: ali.howard@glasgow.ac.uk orelizabeth.mcmeekin@glasgow.ac.uk / 0141 330 6557 or 0141 330 4831

First published: 9 September 2019

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