Implementation of the NHS England Lung Cancer Screening Programme over 5 years
Richard W. Lee, Arjun Nair, Haval Balata, Charlotte Graham, Craig Parylo, Jessica Abell, Michael Woodall, Michael Lawrie, Sally Mouland, Kate Brain, Michelle Clark, Philip A Crosbie, A. Devaraj, J. Fox, Martin Grange, Sam M. Janes, Peter Johnson, Anne Mackie, Neal Navani, Samantha L. Quaife, Amelia Randle, Janette Rawlinson, Robert C. Rintoul, Liz Rochelle, Peter Sasieni, Matthew E J Callister, David R. Baldwin, Ellis Akhurst, Asif Azam, Thilan Rajith Bartholomeuz, Stuart Baugh, A Bibby, Richard Booton, Richard Brindle, Leanne Cheyne, Cyrus Daneshvar, Dhananjay Desai, Jennifer Lisa Dickson, Gurnak Singh Dosanjh, Jacqueline Faccenda, Elizabeth Ruth Fuller, Matt Gabriel Gallardo, Sindy Gill, J. E. Graves, Seamus Grundy, Christopher Hale, Alexander Hicks, John Howells, Ian Hume, M.J. Ledson, Kai En Low, C. Mackinlay, Afsar Madathil, Venkateswaran Mahadevan, Nicola McMaster, Stephen McSwiney, Jenny Messenger, Carol Min, Peer Mohamad Mohamed, Babu Naidu, Kofi Nimako, Jason S. Page, Jason C. Poole, Helen Powell, Baiju Saradananda Prasad, Arvind Rajasekaran, Poppy Richards, Rabinder Singh Randhawa, Kimuli Ryanna, Charlotte Smith, Haarini Sridhar, Rebecca Taylor, Stephanie Uys, Anna Walsham, Christopher James Warburton, Ann Ward, Mark Weatherhead, Tim Windle
Abstract
Lung cancer screening with low-dose computed tomography has been proven to reduce lung-cancer-specific and all-cause mortality. The UK launched the NHS England Targeted Lung Health Check Programme in 2019, which has now become the national Lung Cancer Screening Programme, with full coverage expected by 2030. Here we present the progress and outcomes of the program. People aged 55-74 were offered low-dose computed tomography of the thorax if they had ever smoked and if risk thresholds, as determined by multivariable models, were met. Delivery of the program is through regionally federated clinical infrastructure and leadership, with national strategic, clinical and economic frameworks. The program has invited over two million people, with 7,193 lung cancers diagnosed-63.1% at tumor, node, metastasis stage 1 and 12.6% stage 2-to March 2025. This has increased the early-stage proportion of lung cancer in England over 5 years, particularly in socioeconomically deprived regions. The NHS England Programme exemplifies how large-scale implementation can be achieved at speed through centralized protocols and effective project management. The program has demonstrated feasibility and scalability in reaching high-risk and underserved populations, but needs to further address inequalities in participation. These findings support adoption of lung cancer screening across the UK and globally, and offer practical tools for international adaptation.