Lung cancer continues to be the biggest cause of cancer death globally and accounts for over 35,000 deaths annually in the UK. 5-year survival remains poor at an average of 12%. A significant contributor to these poor outcomes is delayed diagnosis, primarily due to a lack of symptoms in early stage disease. In England, 35% of lung cancers are diagnosed following emergency presentation and of these 90% are stage III or IV. This has led to discussions around the introduction of lung cancer screening with low-dose CT (LDCT) scanning which has been shown to reduce lung cancer mortality.

Whilst lung cancer screening is not currently recommended by the UK National Screening Committee, NHS England has announced plans for £70million funding to rollout screening programmes at 10 sites across the country. This decision was based not only on emerging international evidence for lung cancer screening but also the success of several pilots within the UK.

One of the first programmes was the community-based Manchester ‘Lung Health Checks’ (LHC) which was initially done as a pilot programme between 2016-2018. The positive impact of the pilot led to commissioning by the Manchester Health and Care Commissioning group of an expanded £4.2 million service across the city.

The expanded Manchester Lung Health Checks commenced on 3rd April 2019 and recently completed its baseline round. Mobile units have travelled through four community sites in deprived areas of the city providing a service to participants from 35 GP practices. Ever-smokers, aged 55-80, were invited to attend a LHC and undergo an assessment of respiratory symptoms, spirometry, cardiovascular and lung cancer risk. Those at a higher risk of lung cancer, defined as a PLCONoRaceM2012 score of ≥1.5%, were invited to participate in annual LDCT screening.

In the first year of the commissioned service, over 9,000 LHCs have been undertaken with more than 4,700 participants going on to have a screening LDCT scan. Additionally, a significant proportion of participants have been identified as at high risk of previously undiagnosed smoking related lung disease and cardiovascular disease and/or undergone tobacco addiction treatment. Participant feedback has been extremely positive and the programme has been deemed successful locally. Analysis is now underway with baseline round results expected later this year.

The second round of screening, which was due to commence in April 2020, has been delayed briefly due to the Coronavirus pandemic and is expected to recommence later in the year.

Dr Haval Balata 
Email: haval.balata@mft.nhs.uk
Twitter: @hsbalata