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Authors' response
  1. John Field1,
  2. David Baldwin2,
  3. Kate Brain3,
  4. Anand Devaraj4,
  5. Tim Eisen5,
  6. Stephen W Duffy6,
  7. David M Hansell7,
  8. Keith Kerr8,
  9. Richard Page9,
  10. Mahash Parmar10,
  11. David Weller11,
  12. David Whynes12,
  13. Paula Williamson13
  1. 1Roy Castle Lung Cancer Research Programme, University of Liverpool Cancer Research Centre, London, UK
  2. 2City Campus, Nottingham University Hospitals, Nottingham, UK
  3. 3Institute of Medical Genetics, Cardiff University, Cardiff, UK
  4. 4Department of Radiology, St George's Hospital London, London, UK
  5. 5Department of Oncology, University of Cambridge, Cambridge, UK
  6. 6Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, London, UK
  7. 7Department of Radiology, Royal Brompton Hospital, London, UK
  8. 8Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK
  9. 9Department of Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
  10. 10Medical Statistics and Epidemiology, University College London, London, UK
  11. 11Clinical Sciences and Community Health, Division of Community Health Sciences, University of Edinburgh, Edinburgh, UK
  12. 12School of Economics, University of Nottingham, Nottingham, UK
  13. 13Department of Medical Statistics, University of Liverpool, Liverpool, UK
  1. Correspondence to Professor John Field, Roy Castle Lung Cancer Research Programme, University of Liverpool Cancer Research Centre, Roy Castle Building, 200 London Road, London L3 9TA, UK; j.k.field{at}

Statistics from

We thank Dr Young for his comments on the recent UKLS position statement.1 We are aware of the current studies on chronic obstructive pulmonary disease (COPD) and lung cancer. However, there is no validated lung cancer risk model in the UK which currently incorporates dynamic lung volumes that could be used in the UKLS trial. All the recruited individuals will have spirometry at the time that they are recruited into the UKLS trial, thus data will be available for developing the Liverpool Lung Project risk model.2 3 We do not wish to focus on COPD risk groups for the pilot UKLS trial.

Smoking is the over-riding risk factor in lung cancer. Our measurements will provide further information concerning the potential for COPD as a useful factor in selecting populations that may benefit from screening. We do not have population-based spirometry in the UK to screen populations and there is an issue over the diagnostic crossover between COPD and asthma.

The search for molecular biomarkers and susceptibility genes, which may be used in early detection programmes, has proved challenging; although there are a number of promising candidates,4–7 none, to date, has been validated to a level where they can be used in an early lung cancer clinical trial.


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  • Funding National Institute for Health Research Health Technology Assessment.

  • Patient consent Obtained.

  • Ethics approval The UKLS trial has received Ethical Approval

  • Provenance and peer review Not commissioned; internally peer reviewed.

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