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El CID 2

Improved lung cancer identification by targeted chest X-ray (CXR)

Most commonly lung cancer is diagnosed in the UK following symptomatic presentation to primary care. NICE guidelines have identified the symptoms that should trigger referral for a CXR. Suspicious CXRs should then be urgently referred to secondary care.

We propose to lower the threshold for a CXR for potential lung cancer symptoms ('extra-NICE - the new diagnostic stratagem). This will be compared with current NICE guidance ('NICE'). 'Extra-NICE', our proposed group of symptoms, recommends a CXR if one has not been obtained within the previous four months, the patient is aged 60+ with 10 or more pack years of smoking and a new or altered cough of any duration reported to primary care and/or increased breathlessness or wheezing (whether or not associated with purulent sputum). This feasibility study will explore issues relating to study design as well as consent to assess the feasibility of a major trial.

Study Type




Study Status


Key data

Start date
Jan. 1, 2011
End date
Oct. 30, 2014
Grant value
General enquiries
Prof Kerry Hood
Dr Emma Thomas-Jones
Chief investigators
Dr Richard Neal

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