Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, The University of Liverpool, Roy Castle Building, 200 London Road, Liverpool L3 9TA, United Kingdom.
Cancer Prev Res (Phila). 2014 Mar;7(3):362-71. doi: 10.1158/1940-6207.CAPR-13-0206. Epub 2014 Jan 17.
The UK Lung Cancer Screening trial (UKLS) aims to evaluate low-dose computed tomography (LDCT) lung cancer population screening in the United Kingdom. In UKLS, a large population sample ages 50 to 75 years is approached with a questionnaire to determine lung cancer risk. Those with an estimated risk of at least 5% of developing lung cancer in the next 5 years (using the Liverpool Lung project risk model) are invited to participate in the trial. Here, we present demographic, risk, and response rate data from the first 88,897 individuals approached. Of note, 23,794 individuals (26.8% of all approached) responded positively to the initial questionnaire; 12% of these were high risk. Higher socioeconomic status correlated positively with response, but inversely with risk (P < 0.001). The 50- to 55-year age group was least likely to participate, and at lowest cancer risk. Only 5% of clinic attendees were ages ≤60 years (compared with 47% of all 88,897 approached); this has implications for cost effectiveness. Among positive responders, there were more ex-smokers than expected from population figures (40% vs. 33%), and fewer current smokers (14% vs. 17.5%). Of note, 32.7% of current smokers and 18.4% of ex-smokers were designated as high risk. Overall, 1,452 of 23,794 positive responders (6.1%) were deemed high risk and attended a recruitment clinic. UKLS is the first LDCT population screening trial, selecting high-risk subjects using a validated individual risk prediction model.
(i) better recruitment from ex- rather than current smokers, (ii) few clinic attendees ages early 50s, and (iii) representative number of socioeconomically deprived people recruited, despite lower response rates.
英国肺癌筛查试验（UKLS）旨在评估英国低剂量计算机断层扫描（LDCT）肺癌人群筛查。在 UKLS 中，对年龄在 50 至 75 岁之间的大量人群样本进行问卷调查，以确定肺癌风险。那些在未来 5 年内患肺癌的风险估计至少为 5%（使用利物浦肺项目风险模型）的人被邀请参加试验。在这里，我们展示了前 88897 名被调查者的人口统计学、风险和响应率数据。值得注意的是，23794 名（所有被调查者的 26.8%）对初始问卷做出了积极回应；其中 12%为高风险。较高的社会经济地位与响应呈正相关，但与风险呈负相关（P<0.001）。50 至 55 岁年龄组参与度最低，患癌风险最低。只有 5%的诊所就诊者年龄≤60 岁（而所有 88897 名被调查者中有 47%）；这对成本效益有影响。在阳性反应者中，吸烟者比例高于人口统计数据（40%比 33%），而当前吸烟者比例较低（14%比 17.5%）。值得注意的是，32.7%的当前吸烟者和 18.4%的前吸烟者被指定为高风险。总的来说，在 23794 名阳性反应者中，有 1452 名（6.1%）被认为是高风险，并参加了招募诊所。UKLS 是第一个 LDCT 人群筛查试验，使用经过验证的个体风险预测模型选择高风险受试者。
（i）招募更多的前吸烟者而非当前吸烟者，（ii）50 岁出头的诊所就诊者人数较少，（iii）尽管响应率较低，但仍招募了相当数量的社会经济贫困人群。
