The potential of new screening techniques to intercept lung cancer at an early stage in veteran smokers is the subject of a clinical trial launched at six hospitals across the UK.

The Lung-SEARCH trial is being funded by Cancer Research UK (CRUK), which notes that, on a national scale, 38,000 people a year are diagnosed with lung cancer. The disease is the UK’s biggest cause of cancer mortality, with 33,000 patients dying every year.

The study, which aims to recruit 1,300 long-term smokers with chronic obstructive pulmonary disorder at hospitals in London, Cambridge, Leeds and Leicester over the next two years, will look at whether bronchoscopies and spiral computerised tomography (CT) scans can pick up more cases of lung cancer early on, when the chances of survival are much higher.

Very often the disease is not caught until it is well advanced, substantially reducing the chances of survival, CRUK points out. Lung cancer has one of the worst survival rates of any cancer: only 7% of patients are still alive five years after diagnosis. With some types, however, a five-year survival rate of up to 80% is achievable if the lung cancer is picked up at an early, operable stage.

Half of the trial participants will be randomly assigned to a control group and will continue to receive the standard care for COPD. Patients in this group will have a chest x-ray after five years.

The remaining patients will be asked once a year to give a blood sample and a sample of phlegm for analysis. If doctors find any abnormal cells in the tissue sample following a fluorescence bronchoscopy (which involves inserting a narrow flexible tube with a camera down the windpipe to examine the lungs and collect a sample) and the spiral CT scan, patients will be called in for regular bronchoscopies.

If the tissue sample shows only normal cells, patients will have a bronchoscopy and a CT scan once a year for the next five years.

“Many of the tests that have been used to screen for lung cancer have not been able to pick up very early signs of the disease, so we’re using two new tests which we think could be better at picking up lung cancer earlier,” explained lead investigator Professor Stephen Spiro of University College London Hospitals NHS Foundation Trust.

Patients will continue to receive medical care for COPD during the trial. If any of the tests indicate lung cancer, patients will start treatment straight away, regardless of which trial arm they belong to.