WCLC Sept 2021 | Comparing the performance of lung cancer risk models in the UK
David Baldwin, MD, FRCP, Nottingham University Hospitals, Nottingham, UK, describes research evaluating different multivariate risk models used for defining lung screening eligibility. In the Targeted Lung Health Check screening programme in the UK, the PLCOm2012 and Liverpool Lung Project-v2 (LLPv2) risk prediction models are used to identify screening eligible individuals. Prof. Baldwin also discusses the benefits associated with the UK’s detailed primary care record and how knowledge of smoking status can be utilized to enhance screening eligibility and improve efficiency of intervention. This interview took place at the World Conference on Lung Cancer (WCLC) 2021.
Transcript (edited for clarity)
In the UK, we’re really quite keen to make sure that we target the screening intervention to the group that are going to benefit most. And this is a difficult area, because actually at the moment, the current state of research is not completely clear on how you should do this. In our targeted lung health check program, we’ve elected to use two multivariable models to allow people onto the program...
In the UK, we’re really quite keen to make sure that we target the screening intervention to the group that are going to benefit most. And this is a difficult area, because actually at the moment, the current state of research is not completely clear on how you should do this. In our targeted lung health check program, we’ve elected to use two multivariable models to allow people onto the program. So this is the Liverpool Lung Project version 2 and the PLCOM2012. Either of those models can get entry into the program and then other people are fortunately not eligible, and then there are a number of other exclusion criteria that we apply to try to exclude those people who may not benefit. But what we really do need to know, we really do need to know whether these models truly are the most efficient at selecting people that will be suitable for screening in terms of having early stage cancer detection, which can then be, can be cured. And that’s a requirement for further research.
In the UK, we’re also very lucky to have a very detailed primary care record, which allows us to identify in the population ever smokers. So we can avoid contacting a large proportion of the population who currently will never benefit from screening. But we should also try to develop multivariable models that could be applied to that population to see whether there’s anything that any people that we might be able to exclude further, so not to bother them with something which would just worry them and not actually benefit them. So that’s a source of ongoing research, quite an exciting area still and no doubt will improve the efficiency of the intervention.
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Disclosures
David Baldwin has received honoraria for advice and education sessions from AZ, MSD, BMS and Roche.
