Evidence map›Paper›PMID 41629156›Full record

ArticleThorax2026

Upstaging of screen-detected lung cancers during diagnostic assessment.

Monica L Mullin, Priyam Verghese, Chuen R Khaw, Andrew Creamer, Amyn Bhamani, Ruth Prendecki, Jennifer L Dickson, Carolyn Horst, Sophie Tisi, Helen Hall and 11 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Thorax, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03934866 (The SUMMIT Study), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03934866 active not recruitingnot on this map

The SUMMIT Study: Cancer Screening Study With or Without Low Dose Lung CT to Validate a Multi-cancer Early Detection Test

TypeobservationalSponsorUniversity College, LondonRan2019 to 2030Enrolled13,035ConditionsCancer, Lung CancerArmsLow Dose CT scan
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Monica L MullinLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.ORCID http://orcid.org/0000-0002-0133-8826
Priyam VergheseLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Chuen R KhawLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Andrew CreamerLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Amyn BhamaniLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Ruth PrendeckiLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Jennifer L DicksonLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.ORCID http://orcid.org/0000-0002-9333-8320
Carolyn HorstLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Sophie TisiLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Helen HallLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.ORCID http://orcid.org/0000-0001-7305-8367
Kylie GyertsonUniversity College London Hospitals NHS Foundation Trust, London, UK.
Esther Arthur-DarkwaCancer Research UK & UCL Cancer Trials Centre, University College London, London, UK.
Laura FarrellyMRC Clinical Trials Unit at UCL, London, UK.
John McCabeLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Ricky ThakrarUniversity College London Hospitals NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0001-9793-2223
Arjun NairRadiology, University College Hospital, London, UK.
Anand DevarajRadiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
Neal NavaniUniversity College London Hospitals NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0002-6412-7516
Allan HackshawCancer Research UK & UCL Cancer Trials Centre, University College London, London, UK.
SUMMIT consortium
Sam M JanesLungs for Living Research Centre, UCL Respiratory, University College London, London, UK s.janes@ucl.ac.uk.ORCID http://orcid.org/0000-0002-6634-5939

Funding

Wellcome Trust
6 · The paper itself

Abstract

introductionLung cancer is the leading cause of cancer-related death worldwide. Low-dose CT (LDCT) screening improves outcomes by detecting early-stage cancers as pulmonary nodules. As most are benign, diagnosing these nodules is challenging and often requires surveillance imaging. The aim of this study is to assess the frequency of cancer progression in a lung cancer screening study as measured by tumour stage (T-stage).

methodsSUMMIT is a prospective cohort study assessing implementation of lung cancer screening with LDCT in a high-risk population. Screen-detected lung cancers with clinical tumour stage cT1a-c at time of referral were included. Upstaging was defined as an increase in T-stage from referral to treatment. The date of death was obtained from the National Cancer Registration and Analysis Service. Cox proportional hazards analysis with adjustment for age, sex, Charlson Comorbidity Index and pack years was used to assess mortality between groups.

results390 screen-detected cancers were stage cT1a-c at time of referral. Upstaging occurred more frequently in cT1a (n=48, 56%) compared with cT1b (n=83, 38%) or cT1c (n=34, 40%), p=0.01. The proportion of part-solid nodules was similar between groups (upstaged-N=47, 27%, vs not upstaged-N=45, 21%, p=0.19). 43% of tumours increased T-stage from referral to first treatment (n=165). In participants upstaged, time from referral to treatment was longer (upstaged: 84 days, 46-298 vs not upstaged: 72 days, 43-211, p=0.04). Adjusted overall survival analyses showed an association between upstaging and mortality (HR 1.68, 95% CI 1.13 to 2.51, p=0.01).

conclusionTumour upstaging occurred in nearly half of early-stage cases in a lung cancer screening population. Tumour upstaging was associated with longer time to treatment and poorer outcomes in this population. TRIAL REGISTRATION NUMBER: NCT03934866.

Indexed as

Early Detection of CancerLung NeoplasmsTomography, X-Ray ComputedAgedDisease ProgressionFemaleHumansMaleMiddle AgedNeoplasm StagingProspective StudiesLung CancerNon-Small Cell Lung CancerReferral and ConsultationThoracic Surgery

Identifiers

PMID41629156
PMCPMC13479619

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.