Introduction

Doncaster, UK, implemented the pilot TLHC programme from March 2021. Ever-smokers between 55-75y with high cancer risk scores had low dose CT. Images were analysed by AI and reported by chest radiologists. Significant findings were sent to SRMDT for second read and clinical correlation by experienced radiologist(s) and physicians. Cases are then either upgraded and referred to specialist teams or downgraded. There is a concern of overburdening services with incidental CT findings.

Aims

We aim to look at the effectiveness and safety of the SRMDT.

Methods

Weekly SRMDT database (Apr-2021 to Dec-22) was reviewed. The data was cross-checked with Doncaster cancer database to identify missed cancers.

Results

1779 CTs (16% of total) were discussed at SRMDT (avg. 21 cases per week). Out of 1442 potential specialist referrals, 650 (45%) were upgraded; 792 (55%) were downgraded.
250 lung nodules (44% of discussed) were upgraded as suspected lung cancers: 148 (59%) were confirmed as lung cancers and 4 (1.6%) as other cancers.

9 out of 10 referrals for adenopathy were referred to other MDTs; 5 cancers (55%) were confirmed. Out of 135 breast lesions discussed, 69 were referred and 14 (20%) had cancer. 81 GI abnormalities were discussed, 42, referred, 6 (14%) cancers were confirmed. 20 out of 105 renal lesions discussed were referred,10 (50%) were cancerous.

Cross checking with Doncaster cancer data base confirmed that none of the downgraded cases have presented with cancers.

Conclusion

Screening review MDT in lung cancer screening programme is effective and safe in streamlining referrals to specialist teams.