A study looking at ways to diagnose lung cancer earlier (Study 1a and Study 2)

Cancer type:

Lung cancer
Small cell lung cancer





These two studies were done to find out more about who may be at higher risk of developing lung cancer. Study 1a and Study 2 were very similar, so the research team looked at the results of them together. 

The studies were open for people to join between 2013 and 2018. The team published the results 2024.

More about this trial

When these studies were done, we already knew that smoking plays a big part in the development of various lung diseases. But researchers wanted to find out more about why some people who smoke get lung cancer and others don’t.

Differences in our genes may affect how cells in the airways react to substances in cigarette smoke. In these studies, the researchers wanted to find out if different cells in the airways react to cigarette smoke in the same way or different ways. 

They looked at one or more of these from each person:

  • cells that line the airways
  • cells that line the nose
  • cells in the blood

They looked at cells from people who:

  • were smoking at the time
  • used to smoke 
  • had never smoked
  • had been diagnosed with lung cancer
  • hadn’t been diagnosed lung cancer

Summary of results

Study design
The research team took various cell samples from some people who had lung cancer and some who didn’t. They:

  • took cell samples from the airways during a bronchoscopy test
  • used a small plastic instrument (a curette) to gently remove some of the cells from the lining of the nose (nasal cells)
  • took blood samples

The research team looked at cell samples from a total of 487 people:

  • 301 people with lung cancer
  • 72 people with a non cancerous lung condition
  • 114 people who didn’t have lung cancer or another lung condition

They took a total of 649 cell samples from the nose and airway, and 467 blood samples. They looked for genetic changes in these cells. They compared the results of people with lung cancer to those without. And people who have ever smoked to those who have not.

The results showed that there were differences in the nasal cells of people who have a lung condition compared to those who don’t. This could be lung cancer or another lung condition. This was regardless of whether they were smokers or not.

The results also showed that people who smoke have changes to their immune system Open a glossary item cells. And that people who used to smoke still had changes to these cells after they stopped smoking, sometimes many years later. This increases their risk of lung cancer. 

The research team plan to use analysis of nasal cells to develop a tool to assess an individual’s risk of lung cancer. They hope this will help identify those who are at highest risk of lung cancer. And reduce the number of people who are diagnosed with lung cancer in the future.

More detailed information
There is more information about this research in the reference below. 

Please note, the article we link to here is not in plain English. It has been written for healthcare professionals and researchers.

Smoking-associated gene expression alterations in nasal epithelium reveal immune impairment linked to lung cancer risk
Maria Stella de Biase and others
Genome Medicine, 2024. Volume 16, article number 54.

Where this information comes from    
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Robert Rintoul

Supported by

Cancer Research UK Cambridge Institute
NIHR Clinical Research Network: Cancer
Papworth Hospital NHS Foundation Trust

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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