Dr Liz Fuller, a Consultant Respiratory Physician in Newcastle, recently attended the ERS Presidential Summit in Warsaw, Poland, on behalf of the British Thoracic Society. Entitled ‘New frontiers of respiratory health: the present and future of early detection’, and led by ERS President Prof. Joanna Chorostowska-Wynimko, this Summit aimed to highlight the successes of early detection in lung cancer screening, the potential of health checks to accelerate detection, with a look to the future at the promise of AI and biotechnology.
Liz shared with us her summaries of each of the four main sessions below.
Lung Cancer Screening: a pivotal opportunity for pulmonology in the EU Cancer Plan
The UK is recognised to be leading the way in this area, with much learning from Poland, which is about to start a National Lung Cancer screening programme, and many countries in continental Europe are looking to align its national lung cancer screening programmes with ours. This includes a move towards risk models and following the same approach to Incidental findings.
Health checks: a comprehensive approach to awareness and detection
This session considered using spirometry as a lung check in a similar manner that an ECG is seen for the heart, with many more people having their lung function checked. The discussion included the need to ensure that clinicians are undertaking high-quality spirometry and that the person performing the test has the necessary training. However, this hasn't been proven cost-effective yet in the asymptomatic population, so this is very much looking to the future. Other than ensuring universal access to spirometry where needed with good quality checks, there was nothing specific for the UK to note.
From possibility to reality: delivering on AI's promise
There were notes of caution highlighted in this session, including bias, cybersecurity risks, and overdiagnosis. The need for AI training was also acknowledged to ensure that respiratory trainees are aware of what is available, how to use AI, and when not to use it.
The session outlined the requirement not only for prospective studies, but also for validation of AI models at a point in time, underscoring the need for robust post-market surveillance. For the UK, training and surveillance are probably the most relevant considerations, given that this is a large and growing area, and we need to keep up to date on developments.
Biotechnology: the future for respiratory disease?
This focused on early detection rather than symptom-based detection using biomarkers and liquid biopsies; early diagnosis of lung cancer; multi-omics and microbiome-based research; and the prediction of respiratory disease, including infection. One example is an IVD kit for alpha-1 antitrypsin deficiency, which is more comprehensive and, in addition to improving diagnosis, will hopefully lead to improvements in treatment.
The discussion included concerns about safety, regulation, and ethics in relation to profit, equality of access and knowledge within the medical profession. Similar to AI, it is clearly a large and growing area where the UK needs to keep up to date and to provide training.
Overall, it was a useful and enjoyable meeting, and we look forward to exploring these issues further at the ERS Conference in Barcelona in September.