The Yorkshire Kidney Screening Trial
Research type
Research Study
Full title
Yorkshire Kidney Screening Trial (YKST): a feasibility study of adding non-contrast abdominal CT scan to chest CT scan undertaken in the YLST randomised controlled trial of community-based CT screening for lung cancer in an at risk population to screen for RCC and other abdominal malignancies
IRAS ID
290336
Contact name
Grant Stewart
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
1 years, 11 months, 28 days
Research summary
Summary of Research
Kidney cancer is the 8th most common cancer in Yorkshire. It has a poor survival rate, with only 6 out of 10 patients diagnosed with kidney cancer still alive after 5 years. This is partly because many people with kidney cancer don’t have any symptoms. In some of these people, kidney cancer is only found by chance during investigations for other reasons. In others, it is often not diagnosed until the disease has passed the point at which we can easily cure it. Screening for kidney cancer has the potential to pick up these cancers earlier and increase the number of people who can be cured.
The Yorkshire Lung Screening Trial offers people aged 55-80 with a history of smoking a CT scan as part of a lung health check. This group of people is also at increased risk of developing kidney cancer. Our new study, the Yorkshire Kidney Screening Trial, will piggyback on this trial to offer an extra CT scan for kidney cancer. The extra scan will take 10 seconds. By the end of the study we will understand whether it is workable to roll this out more widely and whether people take up this extra scan.Summary of Results
Background and Study Objectives People who have smoked and are thought to be at high risk of lung cancer are now offered a lung scan check in some parts of England. We wanted to understand whether it would be possible to scan the abdominal area at the same time to check for kidney cancer and other potential problems in that part of the body.Method
We asked 4,438 people aged 55-80 years old, who were already coming for a lung scan in another trial called the Yorkshire Lung Screening Trial, whether they would like to have their abdomen scanned at the same time. Before inviting them, we checked that they had not had an abdominal scan in the previous 6 months, nor been previously diagnosed with kidney cancer, and that they were able to agree to take part themselves.
We recorded what was seen on the additional abdominal scans and followed up what had happened to all the people who had something found on the scan for six months after the scan. In addition, we interviewed 20 patients who had taken part, five people who declined and eight healthcare professionals who were involved in the study, to see what they thought about adding the abdominal scan on to the lung scan.
We also sent 500 questionnaires to a sample of participants to find out how having the scan had affected them emotionally, what they had thought about the information they had been given and the study processes, and whether they had any regrets about having the scan. This enabled us to check if there were any downsides to having the extra scan. We were particularly interested in looking at those who had needed additional investigations and were then told that there was not actually anything to worry about.Results
4438 people attended their lung scan. 97.1% (4,309/4438) were eligible to participate in our study and some of these (6.7%, 290/4,309) did not want to take part. This left 4019 people having the additional abdominal scan.
We found that older people, women and current smokers were significantly less likely to want to take part. Very few of the people completing the questionnaire said that they wished they hadn’t taken part. Only 3.0% (4/133) who had normal results, 3.8% (4/106) who had a finding that did not require any further action, and 8.1% (7/86) who had an abnormal scan which did require further action, regretted participating. The questionnaire results also showed that adding the abdominal scan was not likely to cause any harm to participants’ mental health or financial situation, including those who had an investigation and were then told that there was not anything to worry about.
Both participants and healthcare professionals thought that it made sense to add the scan and that it fitted well into the existing lung scanning process.
The additional time needed for the abdominal scan and other related tasks was 13.3 minutes. The scan itself only added an average of 2.5 minutes. The remainder of the time was administrative tasks, including obtaining consent to take part.
Most people (84.0%) had a normal scan or findings that did not need any further action. 211 (5.3%) had a new serious finding which included 20 (0.5%) cancers, half of which were kidney cancers. We also found 60 (1.5%) people with an abdominal aortic aneurysm - a bulge in the main blood vessel running from their heart to their abdomen, which can be dangerous. Most of the remaining serious findings (91 or 2.3%) were large kidney stones which can cause problems if they are left untreated.
All these people immediately benefitted from involvement in the trial by receiving the appropriate treatment from within the standard NHS care pathways.Conclusions
Most people wanted to have the abdominal scan in addition to the lung scan and it was felt to be acceptable with very few people regretting their decision.
We have identified ways to greatly reduce the additional time that would be needed to add on the abdominal scan to the lung scan.
The number of people who had serious findings was about the same as you would expect in other established UK screening programmes like breast or bowel cancer screening.
The next step is to conduct a cost-benefit analysis for if it were introduced as standard practice by the NHS.REC name
North West - Preston Research Ethics Committee
REC reference
21/NW/0021
Date of REC Opinion
4 Feb 2021
REC opinion
Favourable Opinion