Quality assurance in lung cancer screening

Adnan G Taib; Iain T H Au-Yong; Arjun Nair; Anand Devaraj; Yan Chen; David R Baldwin

doi:10.1093/bjr/tqae229

Quality assurance in lung cancer screening

Br J Radiol. 2024 Nov 19:tqae229. doi: 10.1093/bjr/tqae229. Online ahead of print.

Authors

Adnan G Taib¹, Iain T H Au-Yong², Arjun Nair³, Anand Devaraj⁴, Yan Chen⁵, David R Baldwin⁶

Affiliations

¹ Clinical Research Fellow, Translational Medical Sciences, School of Medicine, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital Campus, Nottingham, NG5 1PB.
² Consultant Thoracic Radiologist, Department of Radiology, Nottingham University Hospitals, Nottingham City Hospital Campus, NG5 1PB.
³ Consultant Thoracic Radiologist, Department of Radiology, University College London Hospitals NHS Foundation Trust, London, NW1 2PG.
⁴ Consultant Thoracic Radiologist, Royal Brompton and Harefield Hospitals London and National Heart and Lung Institute, Imperial College London.
⁵ Professor of Digital Screening, Translational Medical Sciences, School of Medicine, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital Campus, Nottingham, NG5 1PB.
⁶ Consultant Respiratory Physician, Nottingham University Hospitals and Honorary Professor, University of Nottingham, Respiratory Medicine Unit, David Evans Centre, Nottingham City Hospital Campus, NG5 1PB.

PMID: 39563480
DOI: 10.1093/bjr/tqae229

Abstract

The effectiveness of screening programmes is critically dependent on the accuracy of the screening test. Where this relies on clinical expertise, there is an imperative to assure that the level of expertise meets expected standards. In cancer screening involving images, the focus is on the reader. Auditing of results is fraught with difficulty because of the time taken to accumulate enough data with confirmed outcomes to identify underperformance before any harm is done. Late recognition can lead to the need for reanalysis and recall of screening participants with loss of confidence in the programme. External Quality Assurance (EQA) is a method that enables clinical expertise to be tested rapidly by using test datasets with confirmed clinical outcome. In the UK, the breast cancer screening programme has had EQA in place for over 30 years. This article describes the development of the first EQA process in lung cancer screening, using the experience gained from running the breast cancer EQA, and the proposed future developments.

Keywords: Lung cancer; Quality Assurance; Screening.