New research from the University of St Andrews School of Medicine has found that biomarker testing in individuals at risk of lung cancer led to a major reduction in deaths.

This study, conducted with 12,000 smokers and ex-smokers, demonstrates how biomarkers—measurable indicators of biological changes—can identify individuals at high risk of lung cancer, leading to earlier detection and significantly improved outcomes.

Professor Frank Sullivan, along with colleagues from the NHS and the Universities of Dundee, Glasgow, Aberdeen, and Nottingham, led a large-scale trial involving 12,000 smokers and ex-smokers. The study, published Jan. 8 in PLOS ONE, found that testing high-risk individuals with biomarkers led to a 40% reduction in deaths from lung cancer and other causes over five years.

Biomarkers are measurable indicators of biological processes, such as proteins or other substances found in blood or urine. These markers can signal changes in the body that may indicate disease, including cancer, even before symptoms appear. The term "liquid biopsy" is sometimes used to describe this non-invasive method of detection.

Lung cancer remains one of the deadliest cancers globally, with an estimated 2 million new cases and 1.76 million deaths each year. While effective treatments exist, they often come too late because the disease is typically diagnosed at an advanced stage. By using biomarkers to identify high-risk individuals or detect early signs of lung cancer, this approach could help save lives by enabling earlier, more effective treatment.

The research team aims to explore how biomarker testing could enhance lung cancer screening programs currently being developed or implemented in several countries. This targeted strategy could improve the identification of individuals most at risk, ensuring that screening resources are used efficiently and effectively.

Dr. Frank Sullivan, Professor of Primary Care Medicine at the University of St Andrews School of Medicine, highlighted the importance of early detection. "This study, along with others using imaging techniques, shows that earlier diagnosis of lung cancer is now possible. That is good news because, if caught early enough, the improved treatments now available have a much higher chance of success."

This pioneering work underscores the potential of biomarker testing to transform lung cancer diagnosis and reduce premature deaths on a global scale.

More information: Francis Michael Sullivan et al, Five-year mortality in an RCT of a lung cancer biomarker to select people for low dose CT screening, PLOS ONE (2025). DOI: 10.1371/journal.pone.0306163