We can't afford to lose momentum in targeted national lung cancer screening

The NHS England targeted lung cancer screening programme is one of the most important public health achievements of recent years. For a disease that still claims nearly 33,000 lives every year, the shift this programme is delivering—from late, symptomatic diagnosis to early, curable detection is transformational. Across England, we are now seeing lung cancer early detection rates driven by the roll-out of the program.

Since national roll‑out began for people aged 55–74 with a smoking history, over 11,500 lung cancers have already been identified, and more than 75% at an early stage—a dramatic improvement on the historic figure of less than 30%. Furthermore, early-stage detection correlates with the coverage of the population. In lung cancer as a whole, the stage I and II rate exceeds 55% in Cancer Alliances where coverage approaches 100%. Lord Darzi has rightly identified targeted lung cancer screening as the only initiative in recent years that has improved early‑stage diagnosis. 

For those of us who have spent decades trying to shift lung cancer outcomes, this moment matters. When the UK Lung Cancer Coalition (UKLCC) launched in 2005, five‑year survival in the UK was around 8%, among the lowest in Europe. Today, with screening as a major driver, the UKLCC has set a new ambition: 35% five‑year survival by 2035. A target once dismissed as unrealistic is now within reach—if we maintain momentum.

And that is the challenge.

The risk of slowing down

The English National Cancer Plan commits to reaching 100% coverage of the eligible population in England by 2030. We are currently at around 50%. Any slowdown now risks reversing hard‑won progress and undermining public confidence in a programme that is demonstrably saving lives.

Yet lung cancer screening remains the only national screening programme without guaranteed funding beyond 2030. This is a structural vulnerability that must be addressed. Long‑term, ring‑fenced investment—on the same footing as breast, cervical and bowel screening—is essential to protect delivery, quality and equity.

Emerging threats to programme quality

We are also seeing worrying signs at local level. Cost‑cutting within Integrated Care Boards (ICBs) is already affecting high‑performing screening teams, with reports of funds being diverted elsewhere. This is not only counterproductive—it is dangerous. Screening money must be used solely for screening, and clear national guidance is urgently needed to prevent local restructuring from undermining delivery.

The transition away from NHS England oversight adds further complexity. Leadership, data systems and clinical governance must remain stable throughout this shift. At the same time, workforce shortages across radiology, pathology, thoracic surgery and genomics threaten the programme’s ability to sustain early‑stage diagnosis. Screening only saves lives if diagnostic and surgical capacity is there to act on what it finds.

A UK‑wide opportunity

England is leading the way, but the UK picture remains uneven. Wales will begin roll‑out next year, but progress in Scotland and Northern Ireland has been slow. A UK‑wide commitment to targeted lung cancer screening would be a landmark moment for public health.

We cannot afford to lose momentum

Lung cancer screening is working. It is saving lives now. It is reducing inequalities. It is delivering earlier diagnosis at scale. And it is giving us, for the first time, a realistic pathway to transforming lung cancer survival in the UK.

But success is not guaranteed. It requires political commitment, protected funding, a stable workforce and clear national leadership.

Together with the UKLCC, those working in lung cancer must urge the Secretary of State and all national decision‑makers to not let this programme stall. Lung cancer screening is the NHS at its best—innovative, evidence‑driven, and life‑saving. With sustained investment and UK‑wide implementation, it can continue to deliver the transformation already underway.