Lung cancer is one of the most common and serious cancers in Scotland and is often diagnosed at a late stage. Early detection is crucial to improving survival rates. The value of screening for lung cancer with low-dose CT (LDCT) scans has been established, and these scans can also identify other diagnoses earlier.
Additional tests undertaken alongside the CT scan may add value to the lung cancer screening program being rolled out. This study aims to explore the feasibility and utility of a lung cancer screening program with added heart and breathing tests within a single clinic visit.
A Lung Health Check will be offered to people at higher risk of lung cancer, specifically those aged 55-74 with a history of cigarette smoking. This will include a quick and painless LDCT scan, which uses a small amount of radiation to create detailed images of the lungs to detect lung cancer at an early and more treatable stage.
In this "GALACTIC-1" study, the investigators will explore whether structured reporting of the CT scan, combined with additional tests (blood sample, ECG heart trace, and spirometry breathing test), can help identify conditions such as chronic obstructive pulmonary disease (COPD), lung scarring (pulmonary fibrosis), coronary artery disease, heart failure, and early signs of bone fractures (osteoporosis). This enhanced Lung Health Check may improve overall health by identifying and allowing early management of these conditions.
The investigators plan to use the data from the "GALACTIC-1" study to explore AI performance by comparing it to reporting done by doctors. The results will help shape future rollout of lung cancer screening across Scotland, ensuring it is effective, efficient, and beneficial.
The investigators will also have a focus group with patients and interviews with NHS staff to understand their opinions on the screening.
Resident in South Sector NHS GG&C.
Capacity to undertake informed consent.
No active cancer other than non-melanoma skin cancer, monitored localised prostate cancer or localised treated breast cancer.
Aged 55-74 at date of invitation.
CT thorax scan undertaken in prior 12 months.
Does not have capacity to give consent (standard criteria for assessing capacity apply).
Aged <55 or >74 years of age at date of invitation
Weight exceeds restrictions for scanner (>200kg).
Single group
Low dose Chest CT
Diagnostic testLow dose Chest CT
Proportion of eligible invited participants who receive all components of the combined low-dose CT (LDCT) screening and AI-assisted cardiorespiratory diagnostic tests within the study active period.
Number of patients successfully screened per protocol within recruitment timelines
Sensitivity of LDCT for detecting confirmed lung cancer (proportion of patients with lung cancer correctly identified as positive).
Specificity of LDCT for detecting confirmed lung cancer (proportion of patients without lung cancer correctly identified as negative).
Lung cancer detection rate
Proportion of participants found to have lung cancer
Stage distribution of detected lung cancers
The proportion detected at Stage I/II vs. Stage III/IV
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