The practical problems of running a national lung cancer screening program are becoming apparent as Australian centres enter their second year of a five-year trial of low dose CT testing.
With a target of recruiting 2000 current and former smokers to undergo lung cancer screening, Australian centres have found themselves swamped with ineligible applicants while finding it difficult to reach the most at-risk individuals in rural areas.
Describing the progress of the International Lung Screening Trial (ILST), principal investigator Professor Kwun Fong a Brisbane thoracic physician, said centres in Perth, Brisbane, Melbourne and Sydney were about a quarter of the way to enrolling patients for the trial.
The trial’s target group is people aged 55 to 80 who have more than 30 pack-years smoking history. It seeks to evaluate the feasibility of an Australian model of lung cancer screening, and whether it can achieve the 20% reduction in mortality seen in the US National Lung Screening Trial (NLST).
Professor Fong said that recruitment to the trial had been done mostly through media and advertising campaigns, but about 1930 of the 3435 people who had volunteered were ineligible due to age or smoking status.
Trial co-ordinators from WA said they found it more efficient to use GP databases to identify people eligible for screening rather than sending out invitations based on age from electoral rolls.
Another issue identified in the ILST trial is whether there are sufficient radiologists to offer low dose CT screening to large numbers of people and capacity in the specialist medical workforce to provide follow up of results to people who have been screened.