A feasibility study examining the effect on lung cancer diagnosis of offering a chest X-ray to higher-risk patients with chest symptoms: protocol for a randomized controlled trial

HURT, Christopher N, ROBERTS, Kirsty, ROGERS, Trevor K, GRIFFITHS, Gareth O, HOOD, Kerry, PROUT, Hayley, NELSON, Annmarie, FITZGIBBON, Jim, BARHAM, Allan, THOMAS-JONES, Emma, EDWARDS, Rhiannon, YEO, Seow, HAMILTON, William, TOD, Angela and NEAL, Richard D (2013). A feasibility study examining the effect on lung cancer diagnosis of offering a chest X-ray to higher-risk patients with chest symptoms: protocol for a randomized controlled trial. Trials, 14 (1), p. 405.

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Abstract

Background

In order to improve lung cancer survival in the UK, a greater proportion of resectable cancers must be diagnosed. It is likely that resectability rates would be increased by more timely diagnosis. Aside from screening, the only way of achieving this is to reduce the time to diagnosis in symptomatic cancers. Currently, lung cancers are mainly diagnosed by general practitioners (GPs) using the National Institute for Health and Clinical Excellence (NICE) guidelines for urgent referral for chest X-ray, which recommend urgent imaging or referral for patients who have one of a number of chest symptoms for more than 3 weeks. We are proposing to expand this recommendation to include one of a number of chest symptoms of any duration in higher-risk patients.

Methods/Design

We intend to conduct a trial of imaging in these higher-risk patients and compare it with NICE guidelines to see if imaging improves stage at diagnosis and resection rates. This trial would have to be large (and consequently resource-intensive) because most of these patients will not have lung cancer, making optimal design crucial. We are therefore conducting a pilot trial that will ascertain the feasibility of running a full trial and provide key information that will be required in order to design the full trial.

Discussion

This trial will assess the feasibility and inform the design of a large, UK-wide, clinical trial of a change to the NICE guidelines for urgent referral for chest X-ray for suspected lung cancer. It utilizes a combination of workshop, health economic, quality of life, qualitative, and quantitative methods in order to fully assess feasibility.

Item Type:	Article
Research Institute, Centre or Group - Does NOT include content added after October 2018:	Centre for Health and Social Care Research
Identification Number:	https://doi.org/10.1186/1745-6215-14-405
Page Range:	p. 405
Depositing User:	Helen Garner
Date Deposited:	08 Apr 2014 10:29
Last Modified:	18 Mar 2021 23:45
URI:	https://shura.shu.ac.uk/id/eprint/7926

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