Lung cancer screening

Lung cancer is one of the most common cancers in the UK, but outcomes are consistently poor. One reason for this is that people are often diagnosed at a late stage, where there are fewer treatment options available. Across the health sector, there is a desire to improve lung cancer outcomes, but this is complex and needs to be tackled using different approaches.

In England, targeted lung cancer screening is being rolled out nationally to support earlier diagnosis of lung cancer and improve outcomes. Read more about this programme and UK screening recommendations below.

In 2022, the UK National Screening Committee (UK NSC) recommended introducing a targeted lung cancer screening programme across the UK. The UK NSC review included data from a large European trial (NELSON) that used low-dose computerised tomography (CT) scans to screen individuals at increased risk of developing lung cancer. This trial showed a mortality reduction in high-risk individuals who received a low-dose CT scan.

In June 2023, the Government announced the national roll out of a targeted lung cancer screening programme in England. People aged 55 to 74 with a GP record including a history of smoking will be assessed and invited for screenings and smoking cessation services.

This rollout follows the success of the first phase of the Targeted Lung Health Check (TLHC) scheme by NHS England with 76% of lung cancers in those tested caught at an earlier stage. NHSE England will be rolling out the programme, with a focus on reaching 40% of the eligible population by 2025 and plans to reach 100% coverage by March 2030. Once fully rolled out, it is expected to detect cancer in as many as 9,000 people and deliver almost one million scans every year as well as ensuring treatment can be provided treatment earlier.

There are currently no lung health checks taking place in Scotland, Wales and Northern Ireland, however there is scoping activity taking place.

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People aged 55 to 74 with a GP record including a history of smoking will be assessed and invited for an initial assessment.
The initial assessment will involve a health professional asking some questions to determine if someone is at a high risk of lung cancer. If they are, they will then be offered a low dose CT scan of the lungs. Smoking cessation support will also be offered for those who need it.
A low dose CT scan helps to check for changes in the lungs that may be lung cancer. The scan uses x-rays and a computer to create detailed pictures of the lungs from different angles to form a 3D image. If somebody has suspected lung cancer, they will be referred so it can be diagnosed as soon as possible. If other abnormalities are found, they may be invited to screening more regularly.

 

GPs can support lung screening by ensuring that their patients' smoking history is accurately recorded within their patient records to ensure that all eligible patients are invited to a TLHC.

Currently, TLHCs are only available in some areas of England and are not offered across the devolved nations. Where TLHCs are available, not everyone invited to initial assessment will meet the threshold for low dose CT. Therefore, GPs will continue to have a crucial role in the diagnosis of lung cancer. For more  information, please see our resources designed to support GPs diagnose lung cancer early.

 

Tobacco exposure remains the biggest risk factor for lung cancer. Smoking cessation and tobacco control efforts must therefore be continued. We have collated evidence, training and practical resources to support health professionals in their role to advise people how to quit and about the options available to them.

Smoking cessation resources for health professionals

However, lung cancer can also be diagnosed in people who have never smoked. It’s crucial to remain alert to the risk of lung cancer in all patients, to make sure that everyone who develops lung cancer has the best chance of a good outcome.  

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As well as the projects funded as part of the NHS England TLHC programme, there is also other activity happening in the NHS such as in Manchester and Liverpool where eligible people in the local population are being invited to attend a lung health check.

There is also ongoing research activity, including the Yorkshire Lung Screening Trial which is adding to the evidence base around the feasibility of a lung screening programme and SUMMIT, which aims to evaluate a blood test designed to detect multiple types of cancer, including lung cancer.