Defining the road map to a UK national lung cancer screening programme.

Lung cancer screening with low-dose CT was recommended by the UK National Screening Committee (UKNSC) in September, 2022, on the basis of data from trials showing a reduction in lung cancer mortality. These trials provide sufficient evidence to show clinical efficacy, but further work is needed to prove deliverability in preparation for a national roll-out of the first major targeted screening programme. The UK has been world leading in addressing logistical issues with lung cancer screening through clinical trials, implementation pilots, and the National Health Service (NHS) England Targeted Lung Health Check Programme. In this Policy Review, we describe the consensus reached by a multiprofessional group of experts in lung cancer screening on the key requirements and priorities for effective implementation of a programme. We summarise the output from a round-table meeting of clinicians, behavioural scientists, stakeholder organisations, and representatives from NHS England, the UKNSC, and the four UK nations. This Policy Review will be an important tool in the ongoing expansion and evolution of an already successful programme, and provides a summary of UK expert opinion for consideration by those organising and delivering lung cancer screenings in other countries.
Competing Interests: Declaration of interests RWL is funded by the Royal Marsden National Institute for Health and Care Research (NIHR) Biomedical Research Centre, Royal Marsden Cancer Charity. RWL's institution receives compensation from NHS England for time spent in a secondment role for the lung health check programme and as a National Specialty Lead for the NIHR. He has received research funding from Cancer Research UK, Innovate UK (co-funded by GE Healthcare, Roche, and Optellum), Small Business Research Initiative for Healthcare (co-applicant with QURE.AI), RM Partners Cancer Alliance, and NIHR (co-applicant in grants with Optellum). He has received honoraria from Cancer Research UK. SHB reports being clinical lead for cancer for the Leeds office of the West Yorkshire Integrated Care Board and received funding from Cancer Research UK for doctoral research. KB receives funding from the Welsh Government via the Health and Care Research Wales-funded Wales Cancer Research Centre (grant number 517190) and Primary and Emergency Care Research Centre (grant number 517195). MEJC reports being principal investigator for Leeds Lung Health Check and the Yorkshire Enhanced Stop Smoking study (funding from Yorkshire Cancer Research). YC reports being the lead for PERFECTS: the first national External Quality Assurance scheme for lung cancer imaging assessment funded by NHS England and NHS Improvement. AD declares a role as Medical Director for Thoracic Radiology at Brainomix. JKF has received fees for participation in speaker's bureau from AstraZeneca and participation on advisory boards from Epigenomics, NUCLEIX, AstraZeneca, and iDNA; and grant support from Janssen Research & Development. SMJ declares paid advisory board membership for 2017–20 with AstraZeneca, Bard1 Bioscience, Achilles Therapeutics, and Jansen; has received assistance for travel to meetings from AstraZeneca; is grant income lead investigator for GRAIL, GSK, and Owlstone; and is a shareholder in Optellum and BARD1 Lifescience. AM declares her role on the National Screening Committee. RLM declares honorarium from AstraZeneca and has been commissioned by Action on Smoking and Health to produce a report on smoking cessation in targeted lung health checks. AN declares grants from UK Department of Health and Social Care's NIHR Biomedical Research Centre's funding scheme and GRAIL (Summit study); consulting fees from Aidence, Faculty Science, and MSD; support for attending meetings from Takeda; advisory board participation with Aidence and Faculty Science; leadership roles for the British Society of Thoracic Imaging, British Lung Foundation, and NHS England Targeted Lung Health Checks Programme. ELO’D reports research funding from Roy Castle Lung Cancer Foundation. SLQ receives funding from Cancer Research UK (grant number C50664/A24460), Barts Charity (MRC&U0036), and University College London Hospital NHS Trust. RR reports advisory boards and consultancy for Inivata, AstraZeneca, and Olympus Medical and research funding support from Owlstone Medical, Victor Dahdaleh Charitable Foundation, Cancer Research UK, and Asthma and Lung UK. RB declares honoraria from Siemens for speaker fees. DRB declares his role as Clinical Advisor to the UK National Screening Committee, UK Department of Health and Social Care, and honoraria from AstraZeneca, MSD, Roche, and Bristol Myers Squibb. PC reports consultancy for Novartis, Everest Detection, AstraZeneca, and North West eHealth; and stock options for Everest Detection. All other authors declare no competing interests.
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