Today, we’re speaking to Dr Steve Bradley, GP and Senior Clinical Lecturer based within the School of Medicine and Population Health at the University of Sheffield.

Title of paper: General practice chest X-ray rate is associated with earlier lung cancer diagnosis and reduced all-cause mortality: a retrospective observational study

Available at: https://doi.org/10.3399/BJGP.2024.0466

It is known that there is wide variation in the use of chest X-ray (CXR) by general practices, but previous studies have provided conflicting evidence as to whether greater utilisation of them leads to lung cancer being diagnosed at an earlier stage and improves survival. This observational study analysed data from the English national cancer registry on CXR rates for individual general practices, along with stage and survival outcomes; it found earlier stage at diagnosis and improved survival for patients diagnosed with cancer at practices that used the test more frequently. Increasing use of CXR by GPs for symptomatic patients, particularly by focusing on practices that use the test infrequently, could improve lung cancer outcomes.

Transcript

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Speaker A

00:00:00.640 - 00:01:06.820

Hello and welcome to BJGP Interviews. I'm Nada Khan and I'm one of the Associate Editors at the Journal. Thanks for taking the time today to listen to this podcast.

In today's episode, we're talking to Dr. Steve Bradley. Steve is a GP and senior clinical Lecturer based within the School of Medicine and Population Health at the University of Sheffield.

Early diagnosis of cancer has been an area of research that is Steve's real strength. And we're here to discuss his recent paper here in the BJJP titled General Practice.

Chest X Ray Rate is Associated with Earlier Lung Cancer Diagnosis and Reduced All Cause Mortality A Retrospective Observational Study. Hi, Steve, Great to speak again and to talk through this paper.

I suppose I want to start by saying that, yes, we know that earlier diagnosis of cancer is a good thing because it can lead to earlier stages of diagnosis and treatment. And you start the paper with a short discussion about screening for lung cancer.

But talk us through why this, this alone won't solve delays in lung cancer diagnosis and what else we need to be doing.

Speaker B

00:01:07.540 - 00:02:14.620

So, yeah, this context is really important because screening is a hugely important development and the UK has led in many ways on lung cancer screening using low dose ct. And this, we hope is going to be very, very beneficial for patients.

But it would be a mistake to think that this is going to solve the problem of lung cancer. And there's a few reasons for that.

One is that only about half of people who get lung cancer would have been eligible for screening because screening concentrates on the highest risk population. And also we know that only about half of people who are invited for screening actually choose to participate in screening.

So the upshot for general practice really is that most patients are still going to be coming through by symptoms and in the same way.

So screening is good news in terms of lung cancer detection, but we still need to do as well as we can in terms of picking these patients up through symptomatic pathways. And actually, this is something we touched on in an editorial for BJGP about a year or 18 months ago, I think.

Speaker A

00:02:15.020 -...