Thursday 25 January 2018 at 09:12
Abu Dhabi’s new screening programme looks to the future
We all know that lung cancer is hard to spot. Too many patients don’t find out they have the disease until it’s reached an advanced stage.
In fact, in the UK, around 35% of all lung cancer diagnoses are made via the ‘emergency route’ – in other words, when people turn up at a hospital’s accident and emergency department.
That figure is far too high. Few patients diagnosed this way are likely to be eligible for curative treatment, which is why, at Roy Castle Lung Cancer Foundation, we work hard to promote early diagnosis.
We’re also eager to learn about initiatives that can point towards the best ways of detecting lung cancer when it can be treated most effectively.
So we were very interested to learn that the city of Abu Dhabi in the United Arab Emirates (UAE) has introduced screening with low-dosage CT scans. These checks are for people viewed as being at risk of developing lung cancer – in this case, smokers aged 55 and above who have smoked a pack of cigarettes for at least 30 years.
This scheme is being introduced despite the fact that - at present – lung cancer is among the five least common forms of cancer in the area.
"The Abu Dhabi Department of Health is taking a longer-term view. They are trying to spot lung cancer cases early as they expect more people to develop the disease in the coming decades."
Abu Dhabi is introducing a lung cancer screening programme despite lung cancer being amongst the five least common forms of cancer in the area
Using the Global Lung Cancer Coalition’s e-Atlas to compare lung cancer rates between the UK and the United Arab Emirates, we can see that the UAE’s figures (around 9.4 cases per 100,000 population) appear to stack up well against our own (around 30 cases per 100,000).
However, the Abu Dhabi Department of Health is taking a longer-term view – rates of smoking have been increasing, especially amongst Emirati men, in the past 20 years. In other words, they are trying to spot lung cancer cases early as they expect more people to develop the disease in the coming decades.
It will be interesting to see how effective this screening programme proves.
At present, there is no national screening programme for lung cancer in the UK. This is because it isn't clear that screening can save lives, CT scans can pose some risks to patients, and they can be expensive.
If we want to change that situation, we’ll need to show hard evidence of the effectiveness and value of CT screening for lung cancer.
As many of you will know already, we’ve been funding a Lung Health MOT check which launched in Bulwell, Nottingham a year ago. Patients in five practices aged between 60 and 75 with a history of smoking were invited to attend a lung health check appointment by their GP.
Roy Castle Lung Cancer Foundation launched a lung health MOT check in Nottingham last year
High risk patients were offered a low dose CT (LDCT) scan to identify whether they had any nodules on their lungs. In almost 5% of patients, the CT scan revealed small nodules on their lungs. These are not currently malignant. However, these patients are now undergoing interval CT scanning to monitor any growth or changes.
It has also identified patients with early stage lung cancer – unbeknownst to them. They have now received curative lung cancer treatment.
We will use this data and all subsequent information and continue to pressurise the government and Public Health England to implement a national lung cancer screening programme.