Patient Experiences of Using Wearable Health Monitors During Cancer Treatment: A Qualitative Study.

Introduction: Wearable health monitors (WHM) offer minimally invasive, ambulatory monitoring of physiological parameters and activity. WHMs are being used increasingly in healthcare but adoption for patients undergoing cancer treatment is limited in part due to a lack of understanding of patient intentions as they receive treatment. The aim of this study explores the patient experience of using WHMs during their cancer pathway, including barriers and enablers of WHM use.

From the International Association for the Study of Lung Cancer Early Detection and Screening Committee: Terminology Issues in Screening and Early Detection of Lung Cancer-International Association for the Study of Lung Cancer Early Detection and Screening Committee Expert Group Recommendations.

Introduction: To facilitate global implementation of lung cancer (LC) screening and early detection in a quality assured and consistent manner, common terminology is needed. Researchers and clinicians within different specialties may use the same terms but with different meanings or different terms for the same intended meanings.

Methods: The Diagnostics Working Group of the International Association for the Study of Lung Cancer Early Detection and Screening Committee has analyzed and discussed relevant terms used on a regular basis and suggests recommendations for consensus definitions of terminology applicable in this setting.

Chronic Pulmonary Aspergillosis after Surgical Treatment for Non-Small Cell Lung Cancer-An Analysis of Risk Factors and Clinical Outcomes.

Chronic pulmonary aspergillosis (CPA) is a rare but significant complication of lung cancer surgery. Its effect on survival remains unclear. Our aim was to describe the outcomes of the patients who developed CPA following the surgery for non-small cell lung cancer (NSCLC), identify the risk factors associated with its development following lung resection, and evaluate its impact on survival.

When to reinvite initially ineligible populations for targeted lung cancer screening?

Introduction: Targeted low-dose CT lung cancer screening reduces lung cancer mortality. England's Targeted Lung Health Check programme uses risk prediction tools to determine eligibility for biennial screening among people with a smoking history aged 55-74. Some participants initially ineligible for lung cancer screening will later become eligible with increasing age and ongoing tobacco exposure.

Endobronchial lymphoma - A rare cause of airway obstruction.

Endobronchial involvement is a very rare manifestation of Non-Hodgkin's Lymphoma, which if left untreated, may cause airway obstruction and lead to respiratory failure. Only a few cases have been reported in the literature. This aim of this case report is to highlight the importance of having a high index of suspicion of endobronchial lymphoma in patients presenting with endobronchial lesions either in isolation or in conjunction with widespread lymphadenopathy.

Invitation strategies and participation in a community-based lung cancer screening programme located in areas of high socioeconomic deprivation.

Introduction: Although lung cancer screening is being implemented in the UK, there is uncertainty about the optimal invitation strategy. Here, we report participation in a community screening programme following a population-based invitation approach, examine factors associated with participation, and compare outcomes with hypothetical targeted invitations.

Methods: Letters were sent to all individuals (age 55-80) registered with a general practice (n=35 practices) in North and East Manchester, inviting ever-smokers to attend a Lung Health Check (LHC).

The detection, assessment and clinical evolution of interstitial lung abnormalities identified through lung cancer screening.

Introduction: Interstitial lung abnormalities (ILAs) are common incidental findings in lung cancer screening; however, their clinical evolution and longer-term outcomes are less clear. The aim of this cohort study was to report 5-year outcomes of individuals with ILAs identified through a lung cancer screening programme. In addition, we compared patient-reported outcome measures (PROMs) in patients with screen-detected ILAs to newly diagnosed interstitial lung disease (ILD) to assess symptoms and health-related quality of life (HRQoL).

Early Diagnosis and Lung Cancer Screening.

Lung cancer remains the most significant cause of cancer death, accounting for about 20% of all cancer-related mortality. A significant reason for this is delayed diagnosis, either due to lack of symptoms in early-stage disease or presentation with non-specific symptoms common with a broad range of alternative diagnoses. More is needed in terms of increasing public awareness, providing adequate healthcare professional education and implementing clinical pathways that improve the earlier diagnosis of symptomatic lung cancer.

Incidental findings in low dose CT lung cancer screening of high-risk smokers: Results from the Manchester lung Health Check pilot.

Here we report the prevalence of incidental findings (IF) in the Manchester Lung Health Check pilot, which delivered mobile low-dose CT targeted lung cancer screening. 187 IFs were reported in 158 participants (11.2 % of individuals screened; n = 1,409).

Explaining differences in the frequency of lung cancer detection between the National Lung Screening Trial and community-based screening in Manchester, UK.

Background: The frequency of lung cancer detection in the Manchester Lung Health Checks (MLHCs), a community-based screening service, was higher than in the National Lung Screening Trial (NLST) over two screening rounds. We aimed to identify the potential reasons for this difference.

Methods: We analyzed individual-level data from NLST and MLHCs, restricting to MLHCs participants who met NLST eligibility criteria.

The diagnostic pathway in lung cancer patients with best supportive care decisions: are there lessons to be learnt?

Introduction: A proportion of patients with lung cancer will not be suitable for anti-cancer treatment and are managed with best supportive care (BSC). The aim of this retrospective case series analysis was to critically review the use of diagnostic and staging investigations in patients who were ultimately managed with BSC.

Methods: A retrospective review of all lung cancer patients with a multidisciplinary team outcome of BSC from 01 June 2018 to 01 June 2019 was performed.

Risk perception and disease knowledge in attendees of a community-based lung cancer screening programme.

Objectives: In England, a risk-based approach is used to determine eligibility for lung cancer screening. Ensuring effective communication and counselling of risk is therefore increasingly important. In this study, we explore the perception of lung cancer risk in attendees of a community-based screening service, located in socio-economically deprived areas of Manchester.

Lung cancer for the non-respiratory physician.

Lung cancer continues to be the leading cause of cancer death globally. Delayed diagnosis is a major contributing factor to poor outcomes and remains a key challenge to overcome. While debate around the implementation of lung cancer screening for asymptomatic high-risk individuals continues, rapid access to relevant diagnostic tests is essential.

Analysis of the baseline performance of five UK lung cancer screening programmes.

Introduction: Low-dose CT (LDCT) screening reduces lung cancer specific mortality. Several countries, including the UK, are evaluating the clinical impact and cost-effectiveness of LDCT screening using the latest evidence. In this paper we report baseline screening performance from five UK-based lung cancer screening programmes.

Performance monitoring of EBUS for the staging and diagnosis of lung cancer: auditing the Greater Manchester EBUS service against new national standards.

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a pivotal test in lung cancer staging and diagnosis, mandating robust audit and performance monitoring of EBUS services. We present the first regional cancer alliance EBUS performance audit against the new National EBUS specification.

Methods: Across the five EBUS centres in the Greater Manchester Cancer Alliance, data are recorded at the point of procedure, when pathological results are available and at 6 months postprocedure to review any further pathological sampling (eg, at surgical resection) and the outcome of clinical-radiological follow-up.

Implementation and outcomes of the RAPID programme: Addressing the front end of the lung cancer pathway in Manchester.

Introduction: Patients with suspected lung cancer require computed tomography (CT), specialist interpretation of the CT and a consultation with a specialist. Significant time savings could be made with rapid access to these components in the front end of the lung cancer pathway.

Methods: The RAPID programme was launched at Manchester's Wythenshawe Hospital in April 2016.

Analysis of lung cancer risk model (PLCO and LLP) performance in a community-based lung cancer screening programme.

Introduction: Low-dose CT (LDCT) screening of high-risk smokers reduces lung cancer (LC) specific mortality. Determining screening eligibility using individualised risk may improve screening effectiveness and reduce harm. Here, we compare the performance of two risk prediction models (PLCO and Liverpool Lung Project model (LLP)) and National Lung Screening Trial (NLST) eligibility criteria in a community-based screening programme.

Spirometry performed as part of the Manchester community-based lung cancer screening programme detects a high prevalence of airflow obstruction in individuals without a prior diagnosis of COPD.

Background: COPD is a major cause of morbidity and mortality in populations eligible for lung cancer screening. We investigated the role of spirometry in a community-based lung cancer screening programme.

Methods: Ever smokers, age 55-74, resident in three deprived areas of Manchester were invited to a 'Lung Health Check' (LHC) based in convenient community locations.

Attending community-based lung cancer screening influences smoking behaviour in deprived populations.

Objectives: The impact of lung cancer screening on smoking is unclear, especially in deprived populations who are underrepresented in screening trials. The aim of this observational cohort study was to investigate whether a community-based lung cancer screening programme influenced smoking behaviour and smoking attitude in socio-economically deprived populations.

Material And Methods: Ever-smokers, age 55-74, registered at participating General Practices were invited to a community-based Lung Health Check (LHC).

CT screening for lung cancer: Are we ready to implement in Europe?

Lung cancer screening with low-dose CT (LDCT) is already available in certain parts of the world, such as the United States, but not yet in Europe. The recently published European position statement on lung cancer screening has recommended planning for implementation of screening to start within 18-months [1]. Pilot European programmes are already underway, primarily in the United Kingdom (UK), delivering lung cancer screening to their local populations.

Prevention and Early Detection for NSCLC: Advances in Thoracic Oncology 2018.

Lung cancer remains the leading cause of cancer-related mortality worldwide. Tobacco consumption remains the most important risk factor. Although the prevalence of smoking has decreased overall, it continues to be a significant burden for global health.

The cost-effectiveness of the Manchester 'lung health checks', a community-based lung cancer low-dose CT screening pilot.

Background: Previous evaluations of low-dose CT (LDCT) lung cancer screening programmes have taken very different approaches in the design of the informative trials and the methods applied to determine cost-effectiveness. Therefore, it has not been possible to determine if differences in cost-effectiveness are due to different screening approaches or the evaluation methodology. This study reports the findings of an evaluation of the first round of a community-based, LDCT screening pilot Manchester, applying previously published methodology to ensure consistency.

Predicting survival following surgical resection of lung cancer using clinical and pathological variables: The development and validation of the LNC-PATH score.

Introduction: The aim of this study was to develop and validate a simple prognostic scoring system using readily available clinical and pathological variables that could stratify patients according to the risk of death following lung cancer resection. We hypothesized that by using additional pathological variables not accounted for by pathological stage alone coupled with markers of overall fitness a new prognostic tool could be developed.

Methods: Multivariable logistic regression analysis of pathological and other clinical variables from patients undergoing surgical resection of non-small cell lung cancer (NSCLC) were used to determine factors independently associated with 2-year overall survival and so derive the scoring system.

Second round results from the Manchester 'Lung Health Check' community-based targeted lung cancer screening pilot.

We report results from the second annual screening round (T1) of Manchester's 'Lung Health Check' pilot of community-based lung cancer screening in deprived areas (undertaken June to August 2017). Screening adherence was 90% (n=1194/1323): 92% of CT scans were classified negative, 6% indeterminate and 2.5% positive; there were no interval cancers.