My views on the NHS England's pilot LDCT lung screening program has previously been stated (ref 1)
Although the authors of this BMJ editorial acknowledged the concerns involving overdiagnoses and supporting services related to these mobile lung cancer screening facilities, the article is by no means an adequately balanced piece on the issue of cost-effectiveness and true efficacy of this screening process.
It is perplexing given that the UK National Screening Committee has not actually recommended any form of lung cancer screening at this time nor was the analysis of pooled UKLS (UK Lung Cancer Screening Trial) data with NELSON (Nederlands Leuvens Longkanker Screenings Onderzoek: Dutch-Belgian Randomised Lung Cancer Screening Trial) made available, significant resources are invested in an expensive but yet unproven public health program by NHS England.
But then UKNSC has a history of being ignored as Dr Margaret McCartney has previously kindly pointed out (ref 2).
I have no problem with implementation of a safe and cost-effective screening program with proven clinical efficacy (rather than lead-time bias) but to embark on this extensive infrastructure building and promote expansion of ancillary support services to be specifically linked to this screening program risks siphoning and maldistribution of limited funds from other essential services at a time NHS faces one of most difficult financial years.
Can the authors offer any justification for their enthusiastic support of this LDCT screening program instead of waiting another 12 months for the NSC recommendation or the UKLS-NELSON data analysis?
Rapid Response:
Vested interests or unfounded enthusiasm?
Dear Editors
My views on the NHS England's pilot LDCT lung screening program has previously been stated (ref 1)
Although the authors of this BMJ editorial acknowledged the concerns involving overdiagnoses and supporting services related to these mobile lung cancer screening facilities, the article is by no means an adequately balanced piece on the issue of cost-effectiveness and true efficacy of this screening process.
It is perplexing given that the UK National Screening Committee has not actually recommended any form of lung cancer screening at this time nor was the analysis of pooled UKLS (UK Lung Cancer Screening Trial) data with NELSON (Nederlands Leuvens Longkanker Screenings Onderzoek: Dutch-Belgian Randomised Lung Cancer Screening Trial) made available, significant resources are invested in an expensive but yet unproven public health program by NHS England.
But then UKNSC has a history of being ignored as Dr Margaret McCartney has previously kindly pointed out (ref 2).
I have no problem with implementation of a safe and cost-effective screening program with proven clinical efficacy (rather than lead-time bias) but to embark on this extensive infrastructure building and promote expansion of ancillary support services to be specifically linked to this screening program risks siphoning and maldistribution of limited funds from other essential services at a time NHS faces one of most difficult financial years.
Can the authors offer any justification for their enthusiastic support of this LDCT screening program instead of waiting another 12 months for the NSC recommendation or the UKLS-NELSON data analysis?
Reference
1. http://www.bmj.com/content/359/bmj.j5450/rr-0
2. http://www.bmj.com/content/357/bmj.j1824.full.print
Competing interests: No competing interests