Abstract 4220: Liverpool healthy lung project: a primary care initiative to identify hard to reach individuals with a high risk of developing lung cancer
Authors: Field John K. , Gaynor Edward S. , Duffy Stephen W. , Gardner Katy , Hubbert Cathy , Tsintzos Dimitris , Marcus Michael W. , Jones Lisa , Avanitis Rachel , Timoney Michelle , Ledson Martin 
Published: July 2017

Abstract
Introduction: The UKLS CT screening trial has demonstrated that by utilizing a population based approach, a risk prediction algorithm (LLPv2), volumetric based CT nodule detection and a specific management pathway, 80% of the lung cancers detected were Stage I or II, 85% of which were suitable for surgical resection. In the Liverpool region, 2.4% of the screened population were found to have lung cancer at baseline.
Methodology: Liverpool has one of the highest lung cancer mortality rates in England, and double the national average of cases diagnosed. It was decided to tackle this health inequality and the NHS Liverpool Clinical Commissioning Group (CCG) introduced the Liverpool Healthy Lung Programme (LHLP). LHLP, began in February 2016 and aims to increase knowledge in communities, promoting positive messages around lung health, recognizing and tackling fear and fatalism surrounding lung cancer. The LHLP is undertaking coordinated, focused public engagement (Breathe Freely) events, throughout the Liverpool region, starting in neighborhoods with the highest incidence of lung cancer. These events are followed by patients between the ages of 58-70 who have COPD, or have smoked, being invited to a local face to face lung health check, conducted by a lung-health nurse working in local community clinics and in partnership with General Practice.
Summary & Findings: This assessment of lung health involved calculation of their risk of developing lung cancer in the next 5 years (My Lung Risk). Those who triggered a 5% threshold were offered low dose thoracic CT. In the Liverpool CCG Region 34,000 patients will be eligible: in the initial 12 weeks in the first neighborhood, 1014 of 2471 (41%) eligible individuals booked to attend the lung health check (865 attended), 351 (41%) triggered the offer of a CT appointment. 306 scans have been reported; 31 (10%) had lung nodules. 59 (20%) had a noncancer significant finding managed in General Practice. To date, September, 4 have confirmed lung cancer with surgical resection; 2 on follow-up. 406 patients (45%) were not previously diagnosed with COPD, 225 (45%) had abnormal spirometry, and were referred. 238 (28%) accepted lifestyle referrals (e.g. smoking, exercise).
Conclusion: The project is over 3 years. Projections suggest 34,000 participants will be eligible. We are aiming for an ambitious 70% uptake meaning 24,000 will have a face to face lung health check. We estimate that ~150 cases of lung cancer will be diagnosed
Citation Format: John K. Field, Edward S. Gaynor, Stephen W. Duffy, Katy Gardner, Cathy Hubbert, Dimitris Tsintzos, Michael W. Marcus, Lisa Jones, Rachel Avanitis, Michelle Timoney, Martin Ledson. Liverpool healthy lung project: a primary care initiative to identify hard to reach individuals with a high risk of developing lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4220. doi:10.1158/1538-7445.AM2017-4220