Neal, RD orcid.org/0000-0002-3544-2744, Barham, A, Bongard, E et al. (15 more authors) (2017) Immediate chest X-ray for patients at risk of lung cancer presenting in primary care: randomised controlled feasibility trial. British Journal of Cancer, 116 (3). pp. 293-302. ISSN 0007-0920
Abstract
Background: Achieving earlier stage diagnosis is one option for improving lung cancer outcomes in the United Kingdom. Patients with lung cancer typically present with symptoms to general practitioners several times before referral or investigation. Methods: We undertook a mixed methods feasibility individually randomised controlled trial (the ELCID trial) to assess the feasibility and inform the design of a definitive, fully powered, UK-wide, Phase III trial of lowering the threshold for urgent investigation of suspected lung cancer. Patients over 60, with a smoking history, presenting with new chest symptoms to primary care, were eligible to be randomised to intervention (urgent chest X-ray) or usual care. Results: The trial design and materials were acceptable to GPs and patients. We randomised 255 patients from 22 practices, although the proportion of eligible patients who participated was lower than expected. Survey responses (89%), and the fidelity of the intervention (82% patients X-rayed within 3 weeks) were good. There was slightly higher anxiety and depression in the control arm in participants aged >75. Three patients (1.2%) were diagnosed with lung cancer. Conclusions: We have demonstrated the feasibility of individually randomising patients at higher risk of lung cancer, to a trial offering urgent investigation or usual care.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2017, Cancer Research UK. This article is made available under the Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. |
Keywords: | lung cancer; early diagnosis; health economics; chest X-ray; NICE; RCT; symptoms; cough |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Primary Care (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 27 Mar 2017 16:12 |
Last Modified: | 10 Jan 2018 01:38 |
Published Version: | https://doi.org/10.1038/bjc.2016.414 |
Status: | Published |
Publisher: | Cancer Research UK |
Identification Number: | 10.1038/bjc.2016.414 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:114206 |