Implementation of the NHS England Lung Cancer Screening Programme over 5 years

Sep 22, 2026

Low-dose computed tomography lung cancer screening has been shown to reduce lung-cancer-specific and all-cause mortality, and the UK scaled this approach through the NHS England Lung Cancer Screening Programme. Adults aged 55–74 with smoking history were offered thorax LDCT when multivariable risk thresholds were met. Delivery relied on regionally federated clinical infrastructure with national strategic, clinical, and economic frameworks. By March 2025, over two million invitations had resulted in 7,193 diagnoses, with increasing early-stage proportions and feasibility for underserved populations. Further work is needed to address participation inequalities.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages18

Reading Time45 min

AccessFree to download

Results

Whole-program lung screening performance metrics

nature medicine Article [https://doi.org/10.1038/s41591-026-04292-y](https://doi.org/10.1038/s41591-026-04292-y) Implementation of theNHS England Lung Cancer Screening Programme over 5 years Received: 1 September 2025 Accepted: 16 February 2026 | Published online: 23 March 2026 | | --- | | Check for updates | Richard W. Lee 1,2,3,4,60, Arjun Nair5,60, Haval Balata6,7, Charlotte Graham4, Craig Parylo 8, Jessica Abell 4, Michael Woodall8, Michael Lawrie 9, Sally Mouland9, Kate Brain10, Michelle Clark11, Philip Crosbie7, Anand Devaraj3,12, Jesme Fox13, Martin Grange14, Sam M. Janes 15, Peter Johnson 4,16, Anne Mackie17, Neal Navani 15, Samantha L. Quaife18, Amelia Randle19, Janette Rawlinson 20, Robert C. Rintoul 21,22, Liz Rochelle17, Peter Sasieni 18, Matthew E. J. Callister 23,24 & David R. Baldwin 25 on behalf of UK Lung Cancer Screening Research Consortium* 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 outcomesofthe program. People aged 55–74 were offered low-dose computed tomography of the thorax if they had ever smokedandifrisk 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 insocioeconomically deprived regions. TheNHS England Programme exemplifies how large-scale implementation can be achieved at speed through centralized protocolsand 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. Lung cancer screening with low-dose computed tomography (LDCT) of the thorax has been shown by several randomized controlled trials to reduce lung-cancer-specific and all-cause mortality1,2. Globally, national-level progress in lung cancer screening varies from continued research, through evaluation of the clinical and cost-effectiveness of small pilot projects to full-scale implementation of national screening programs. The National Health Service (NHS) England Lung Cancer Screening Programme, known in its earlier, large-scale pilot phase asthe Targeted Lung Health Check (TLHC) Programme, was launched in 2019, with the aim to improve the proportion of cancer detected atanearly stage in England. NHS England had recently seta target of 75% of people with any cancer being diagnosed at stage 1 and 2 by 2028. The pilot was also expected to provide real-world evidence ahead of a revised evaluation by the UK National Screening Committee. The goal was to create a national strategic, clinical and economic framework, within which to achieve full-scale deployment. The pilot constituted an important A full list of affiliations appears at the end of the paper. [e-mail:](e-mail: Richard.Lee@rmh.nhs.uk)[ Richard.Lee@rmh.nhs.uk](e-mail: Richard.Lee@rmh.nhs.uk) contribution to the national early cancer diagnosis agenda, while identifying challenges and solutions to clinical referral pathways for lung cancer and other clinically relevant findings. This would also inform commissioning budgets for a full rollout. The program adheres to a detailed national protocol3 and quality assurance standard4, through regionally federated clinic

FAQs

What was the eligibility approach for offering LDCT in the program?

People aged 55–74 with a smoking history were offered low-dose computed tomography of the thorax when multivariable risk thresholds were met.

What outcomes were reported by March 2025?

By March 2025, the program had invited over two million people and diagnosed 7,193 lung cancers, including a higher proportion of early-stage disease over 5 years.

How was the program implemented at scale across England?

Implementation used regionally federated clinical infrastructure and leadership, guided by centralized national strategic, clinical, and economic frameworks and protocols.

Sep 22, 2026

Upload by Pentious