TACTICAL1 stands for Targeted Abdominal CT in Conjunction with Lung Cancer Screening.  It is a randomised controlled pilot study of adding abdominal non-contrast CT to Lung Cancer Screening CT Thorax amongst high lung cancer risk ever-smokers aged 55-70. Or, more simply put, testing whether adding a quick tummy scan to routine lung cancer screening can help detect other serious illnesses earlier. 

Background
Early detection through screening can improve cancer survival by identifying it when it's most treatable. The NHS now offers Lung Cancer Screening (LCS) assessments to people aged 55–74 who have ever smoked. Those at higher risk of lung cancer are offered a lung scan.

This group also has a high risk of developing abdominal cancers, such as kidney cancer. A recent study called the Yorkshire Kidney Screening Trial, explored whether it would be feasible to extend the lung scan to include the abdomen. Results showed most participants supported this addition, and the number of serious findings was similar to those detected in UK breast or bowel cancer screening programmes.

However, the abdominal scan was only offered on the day of the lung scan, giving little time for people to consider their decision. The process also added too much time to be practical for widespread implementation.

Objectives
This new study will:
- Test whether mentioning the possible abdominal scan in the initial LCS invitation affects participation in LCS assessments.
- Test new processes to assess if the abdominal scan can be added to the lung scan with minimal extra time.
- Check if participants can be split between the lung scan only group and lung and abdominal scan group using an approach called 'cluster randomisation'. This will be important in case a bigger trial is needed.
- See whether the additional processes are acceptable

Who can take part?
People aged 55-70 who are invited to lung cancer screening in the participating locations during the trial recruitment period will be eligible to take part in this study. Only those who are found to be at a high risk of lung cancer after their assessment, and therefore offered a lung scan, will be offered the abdominal scan, provided they have not had an abdominal scan in the previous 12 months or one booked in the next 3 months.

This study will take place in two existing lung cancer screening locations in Yorkshire.

Results
The findings will be shared here once available.  If you would like to receive an email when the results are published please register here: https://redcap.link/TACTICAL

For more information
TACTICAL1 is led by Professor Grant Stewart as Chief Investigator and sponsored by the University of Cambridge (UoC). The trial is funded by Yorkshire Cancer Research.

If you have any questions about the research please contact us on screening@urology.cancer.cam.ac.uk.