England’s lung cancer screening programme

A new study published in Nature Medicine provides the clearest evidence to date that lung cancer screening can be delivered effectively at a national scale within a public health system. In England, the NHS has seen substantial success in reaching people at the highest risk and shifting diagnosis to earlier, more treatable stages.

The paper reports on five years of implementation of the NHS England Lung Cancer Screening Programme, which evolved from the Targeted Lung Health Check (TLHC) pilots launched in 2019.

The programme offers low-dose computed tomography (LDCT) screening to people aged 55–74 with a history of tobacco use who meet defined risk thresholds, using a regionally delivered model underpinned by national clinical, economic and quality frameworks.

By March 2025, more than 2 million people had been invited to participate, with over 7,000 cases of lung cancer detected. Crucially, nearly three‑quarters of people were diagnosed at stages I or II, which represents a dramatic reversal of the oftentimes late‑stage presentation seen all too frequently in routine care. The study also highlights progress in reducing long-standing inequalities, with particularly strong earlier stage detection in geographical areas of socioeconomic deprivation.

These findings reinforce clear policy messages for screening implementation: that national governance, risk‑based eligibility, robust data systems and appropriately tailored delivery models are needed to translate evidence into population‑level change.

England’s experience echoes lessons from other programmes, including the importance of embedding screening within broader lung cancer care and lung health pathways, and aligning workforce, infrastructure and quality assurance from the start.

As more countries move from pilots to policy, England’s national programme offers more than proof of concept. It is demonstrating real-world change and delivering practical insights for others to adapt. For this programme, which is targeting full coverage by 2030, it will be important to address outstanding challenges in low uptake and continue to focus on equitable benefits for everyone at high risk of the disease.

Learn more about the history of England’s lung cancer screening programme in our case study.