YLST

The Yorkshire Lung Screening Trial invited 44,943 people; 50.8 percent responded, with response significantly lower among current smokers (adjusted odds ratio 0.44) and in the most deprived fifth (0.58). Of responders, 34.4 percent were eligible and offered a lung health check, 86.8 percent attended and 99.7 percent of those eligible had a baseline scan.

Its most consequential result compared the three eligibility rules a programme might use. Of responders, the PLCOm2012 model at a six-year risk of 1.51 percent made 28.0 percent eligible and captured 91.1 percent of all the cancers; the Liverpool Lung Project model version 2 at 5 percent made 20.5 percent eligible and captured 77.0 percent; the 2013 United States Preventive Services Task Force criteria made 18.9 percent eligible and captured 62.8 percent. Even at equal numbers screened the risk models beat the categorical rule. Cost-effectiveness was comfortable for all three, from 3,797 to 4,013 pounds per quality-adjusted life-year. A stop-smoking practitioner co-located with the scanner was accepted by 89 percent of eligible smokers, and 12.4 percent were carbon-monoxide-validated quitters at four weeks. Adherence to the second round was 86.8 percent.