New study aims to revolutionize how we detect lung cancer early
A major new study, currently recruiting across several UK regions, could transform how doctors identify lung cancer at an earlier, more treatable stage. The MEDLEY trial brings together researchers from the Universities of Leeds, Sheffield, Exeter and Nottingham, along with Queen Mary University of London and University College London, to compare low-dose CT scans with the standard chest X-ray as a first-line test for patients with worrying respiratory symptoms.
Why MEDLEY matters: tackling a leading cancer killer
Lung cancer remains the UK’s deadliest cancer, with many cases still diagnosed after a chest X-ray ordered by a GP. Chest X-rays can miss up to around 20% of lung cancers, raising the risk that patients are diagnosed later when treatments are less effective. The MEDLEY trial hypothesizes that low-dose CT scans, which provide more detailed images, could identify cancers sooner and save lives by enabling earlier intervention.
How the trial works
In MEDLEY, 900 volunteers who visit their GP with worrying respiratory symptoms and are referred for a chest X-ray will be invited to participate. All participants will receive the standard chest X-ray; additionally, those who consent will undergo a low-dose CT scan. The CT results will be shared with the patient’s GP, ensuring no delay in clinical care. The trial is designed to determine whether CT scans catch cancers earlier than X-rays and to explore the broader diagnostic information these scans may reveal.
Practical considerations
Low-dose CT scans expose patients to a level of radiation comparable to what we experience in daily life over a week, a point researchers emphasize to address safety concerns. While CT scans are more expensive and take longer to perform than X-rays, MEDLEY will assess whether the potential lives saved justify the broader use of CT screening in primary care settings.
Is there a plan to roll out if the trial succeeds?
If MEDLEY demonstrates clear benefits from using low-dose CT as a first-line test, the Department of Health could support wider adoption. However, NHS resources are stretched, so one likely outcome is a phased approach that prioritises patients based on risk factors such as age and smoking history to identify those most likely to benefit from a CT scan. The study’s design also seeks to create practical criteria for when CT should replace X-ray in routine GP practice.
Impact on patients and the healthcare system
“We need to diagnose lung cancer early, when treatments are most effective,” says Professor Mat Callister, a key member of the MEDLEY team. He notes that while the NHS may not be able to offer CT scans to every patient with respiratory symptoms immediately, MEDLEY could help identify which patients would gain the most from an early CT scan. Professor Anthony Gordon of the NIHR HTA Programme adds that funding high-quality studies like MEDLEY is essential to reduce the impact of major killers and offer patients longer, healthier lives.
About the funding and timeline
The MEDLEY study has secured 1.2 million in funding from the National Institute for Health and Care Research (NIHR) and is expected to conclude within three years. The trial’s findings could influence future guidelines for initial cancer testing and shape how clinicians balance cost, accessibility, and diagnostic accuracy in primary care.
For patients and families facing the possibility of a lung cancer diagnosis, MEDLEY represents a proactive step toward earlier detection and potentially better outcomes, should the trial results support broader use of low-dose CT scans in place of chest X-rays as a first-line test.
