Lung Health Checks are being offered to people in Leeds between 55 and 80 years old who are current or ex-smokers as part of the Yorkshire Lung Screening Trial, funded by Yorkshire Cancer Research. 73 General Practices across Leeds are participating in the study.
I am a GP in Leeds taking part in the study – how will I hear about the Lung Health Check results for my patients?
The results from the Lung Health Check and Low-Dose Thoracic CT scan will be reviewed by the clinical team, and separate letters sent to the patient and GP. The CT report itself will not be sent. Where further investigation is required within secondary care, this will be arranged by the study team. This includes CT surveillance for indeterminate pulmonary nodules, and referrals to the lung cancer service for patients where the CT scans suggests possible lung malignancy. The patient’s GP will be copied into all correspondence. Where further action is needed in primary care, this will be communicated by letter describing the specific action required.
You are measuring spirometry – how will this result be communicated to primary care?
Spirometry values (FEV1 absolute value and % predicted, FVC absolute value and % predicted, and FEV1/FVC ratio) will be included in all correspondence about the Lung Health Check results (this will be pre-bronchodilator spirometry) including a comment about the significance of the findings. Where a patient’s spirometry result show airflow limitation, and there is not a coded diagnosis of COPD present in the patient’s Primary Care record, a referral will be made to the Community Respiratory Team for further assessment, confirmation of diagnosis, and if needed treatment.
The CT scan may also show emphysema – should that alter patient treatment?
Other than encouraging smoking cessation, the presence of emphysema on CT scan does not in itself require any specific treatment. For this reason, we will not communicate the presence of absence of emphysema in the results letter to the patient or GP.
The CT scan may also show evidence of coronary artery calcification – should that alter patient treatment?
There is no current UK guidance that includes Coronary Artery Calcification as a factor in determining provision of primary prevention for Ischaemic Heart Disease. We will not therefore communicate the presence of absence of coronary artery calcification in the results letter to patient or GP. NICE recommends primary prevention for all patients with a QRISK-2 score of ≥10%.
All patients will be asked whether they have chest pain suggestive of angina as part of their Health Check. Any patient who reports this as a new finding will be asked to see their GP for further assessment. This will happen irrespective of the presence of Coronary Artery Calcification on their CT scan.
What smoking cessation provision is offered for people attending for their Lung Health Check?
Smokers attending for a Lung Health Check will see an on-site Smoking Cessation Practitioner (SCP) for immediate intervention including provision of Nicotine Replacement Therapy or an e-Cigarette where they wish. Where patients prefer to use Varenicline or Bupropion, the SCP will complete a treatment advice note and ask the patient to visit their GP to get this prescribed. On-going smoking support will be provided either as part of a linked research study called the Yorkshire Enhanced Stop Smoking Study (click here for more information) or by One You Leeds for people who do not wish to take part in the research study.
Who can I contact about the study?
If you have further questions about the study, please contact
- firstname.lastname@example.org (checked daily by the trial team)
- The YLST office on 0113 392 6688 (staffed Monday-Friday 09.00-17.00)
- YLST Project Manager – Irene Simmonds, email@example.com
- YLST Chief Investigator – Dr Mat Callister, firstname.lastname@example.org
Information about the trial design is available at the following website https://doi.org/10.1186/ISRCTN42704678