Lung Cancer Screening

Lung Cancer Screening (formerly known as Targeted Lung Health Checks) is a screening programme for people aged between 55 and 74 who have ever smoked.

They are currently offered in parts of England where there is a high incidence of smoking and lung cancer but will roll out to the whole of the country by 2029.

In Cheshire and Merseyside, they are being offered in Wirral, Warrington, Liverpool, Halton, Knowsley, St Helens and South Sefton. They will roll out to north Sefton and the rest of Cheshire in 2026.

You can watch a video which explains what they are - with BSL - here.

In June, 2023, the Government announced that Lung Cancer Screening was now a national screening programme, which will roll out to cover the whole of the country over the next several years. You can read this announcement here.

For more information about the programme, for health workers, participants and the public, click here and also see the following sections:

Lung Cancer Screening (formerly known as Targeted Lung Health Checks) began in 2016 and is working with communities across Wirral, Warrington, Halton, Knowsley, Liverpool, South Sefton and St Helens. People who are eligible will be given an appointment for a check-up. It is a great opportunity to give your lungs an MoT so that we are able to help diagnose lung conditions earlier, including cancer when it is more effective to treat.

Liverpool Heart and Chest Hospital is the Lead Provider for the programme, working in collaboration with local NHS teams.

Cheshire and Merseyside Cancer Alliance co-ordinated the screening in South Sefton and St Helens, which began in autumn 2022 and ended in early 2024 and continues to organise them in Wirral and Warrington where they are running in in 2025.

The checks are due to begin in north Sefton in late 2025 and in the rest of Cheshire in 2026.

The programme is was one of the first projects to be launched under the NHS Long Term Plan.

The NHS Long Term Plan, published in January 2019, set out a wide range of ambitions for the NHS to achieve over the following 10 years.

A number of these ambitions centre on improving cancer survival through earlier diagnosis, with the Plan committing to increase the proportion of cancers diagnosed early from half to three-quarters by 2028.

This increase would mean 55,000 more people each year surviving for at least five years after diagnosis.

The NHS recognises that lung cancer is an area where early diagnosis is desperately needed to help improve survival and NHS Lung Cancer Screening is, therefore, taking place in areas with some of the highest rates of lung cancer deaths in England.

As well as helping to diagnose lung cancer at an early stage, Lung Cancer Screening also helps to identify other lung conditions.

The Government announced in June, 2023, that this check was now a national screening programme which would cover the whole of England over the next few years.

Lung cancer is often diagnosed at a late stage because symptoms are not always apparent until the disease is advanced, or because people are too worried about being diagnosed with lung cancer to seek help.

NHS Lung Cancer Screening helps to detect early-stage lung cancers, often before people have any symptoms and at a point when treatment is simpler and more successful. This is done by identifying those people most at risk of developing lung cancer and offering them a CT scan. The CT scan can help identify early changes.

A recent study (NELSON Lung Cancer Trial) showed that scanning people at higher risk of developing lung cancer reduced mortality (death) from the disease by 26% in men and between 39% and 61% in women.

It is expected that the detection of lung cancers through the Lung Cancer Screening programme, many of which will be at an early stage, will mean that thousands of lives are saved.

People aged 55 to 74 years old who have a history of smoking are given a lung health check appointment over the phone.

You will be given an appointment by text message or letter for your free NHS Lung Cancer Screening. If you receive an appointment, which is sent jointly by Liverpool Heart and Chest Hospital and your GP practice, please follow the instructions.

Please do not ignore it.

At this appointment, patients may be offered a Chest CT Scan at a mobile scanning unit near to where they live for further investigations, if required.

It is important that people's smoking status is recorded correctly on their GP practice record so that they receive an invitation. If you are not sure whether it is, please check with your surgery.

Lung Cancer Screening is done on the phone. A specially-trained NHS team, including nurses, will phone or contact you within 15 minutes of your agreed appointment time to carry out your check. The appointment will last around 30 to 45 minutes.

You will be asked a number of questions about your health, lifestyle and history, including any personal history of cancer or family history of lung cancer. The answers will be used to assess your risk of developing lung cancer in the future.

If you are assessed as being at increased risk of lung cancer, you will be offered a low dose CT scan. If you are offered a scan, the caller will talk you through the benefits and risks of this, and you will be able to ask any questions you may have. An appointment for your CT scan will then be booked for you.

After your scan, you will receive your results within around four weeks. Your GP will also be contacted with the results of your scan.

Click here to watch this video of what to expect at your lung check CT scan.

Your lungs are a part of your body that work hard every day so you can breathe. They do not get much rest as in one day you can breathe up to 25,000 times!

Your lungs carry oxygen from the air into your blood and release carbon dioxide from your blood into the air. Your body’s cells need this oxygen to work properly. Your lungs have a natural defence system to keep out dirt and germs but several things can damage this, meaning they can’t do their job as well.

There are lots of things that you can do to look after your lungs, which are just as important if you already have a lung condition, including:

being more active
eating a balanced diet
stopping smoking
making sure you have all your vaccinations if you are over 65 years old or have a long term condition
knowing the warning signs and symptoms of lung conditions including Chronic Obstructive Pulmonary Diseases (COPD) and lung cancer.

General information about the checks from the Roy Castle Lung Cancer Foundation

Frequently Asked Questions about Lung Cancer Screening

What is the Lung Cancer Screening programme?

It is a check for those aged 55 to 74 who have ever smoked. It is a process with two stages. There is a conversation with a health professional and then, if needed, there is a simple CT scan, which can identify signs of cancer at an early stage when it is much more treatable. The programme started in 2019 and is now being extended to more areas of the country, with further areas added over time. In Cheshire and Merseyside, the checks initially started in Liverpool, Halton and Knowsley, St Helens, south Sefton and is now expanding across Wirral and Warrington. Soon they will be in north Sefton and the rest of Cheshire.

What is the aim of screening?

The aim is to detect lung cancer and disease early so people can be treated sooner and more effectively – ultimately saving more lives.

Lung cancer often has no symptoms in the earlier stages, which can result in it not being found until the later stages when outcomes are less favourable.

How does the NHS choose which areas will take part in the programme?

From data on the number of smokers in each area and incidence of lung cancer. Areas with the highest smoking and lung cancer rates were chosen to have the checks first as this will have the biggest impact.

Who is carrying out the screening?

Liverpool Heart and Chest Hospital is doing the screening with information from GP practices across Cheshire and Merseyside. The CT scans take place in a mobile scanning unit within your community.

I'm under 55. Why can't I have a check?

Currently, Lung Cancer Screening is just for people aged 55-74 who have ever smoked. These checks are proven to be beneficial in medical research in this age group. Below this age we do not have enough evidence that there will be a definite benefit to people. However, anyone can get lung cancer, so if you have any concerns or are experiencing symptoms, contact your GP practice immediately.

Why is Lung Cancer Screening available to people who have smoked?

This is because they are at a higher risk of lung disease or lung cancer than people who have never smoked. However, anyone can get lung cancer, so if you have any concerns or are experiencing symptoms, contact your GP surgery immediately.

I've quit smoking, so why do I need to go?

Well done for successfully quitting smoking. In doing so, you have reduced your risk of getting lung cancer. However, you still have a higher risk of lung cancer than someone who has never smoked, so you should still go for the check.

I'm over 74. Why can't I have Lung Cancer Screening?

Medical research has proven that the checks are beneficial to people in this age group. We do not have enough evidence to know if people above this age will have benefit from them. The main concern is that the risks from treatment begin to outweigh the benefits of screening from 75 years and over. However, anyone can get lung cancer so if you have any concerns or are experiencing symptoms, contact your GP surgery immediately.

Why is screening not offered to people who have experienced passive smoking?

Research is not yet available to show that people who have never smoked, have smoked very low amounts, or who have experienced passive smoking will benefit from screening. However, anyone can get lung cancer so if you have any concerns or are experiencing symptoms, contact your GP surgery immediately.

Why are CT scans only offered to some people who have Lung Cancer Screening?

The screening appointment will identify people who have a higher risk of lung cancer and they will then be offered a low dose CT scan. Medical research has shown us that people who meet this risk threshold are most likely to benefit from a CT scan because lung cancer may be found early. For people who do not meet the risk threshold, we do not have enough evidence that they will benefit, compared to the potential harms of having a CT scan. However, anyone can get lung cancer so if you have symptoms that are worrying you, contact your GP practice immediately.

I'm scared about what they might find at the appointment

It's completely understandable that you might be a little nervous about having a lung check, but it is really important that you go. If you have a scan, you can request that someone goes with you to the appointment, such as a family member or friend. The chances are that everything will be ok and your lungs will be totally healthy, but if it is lung cancer, catching it early can make all the difference.

There's a history of lung cancer in my family so can I be tested?

There is currently no proof from medical research that an inherited risk of cancer alone can reliably tell us who is more at risk of developing lung cancer. Smoking history is proven to be the best measure for identifying who should have lung screening because former or current smokers are more likely to develop lung cancer. However, we do take family history into account in risk assessment part of the screening process.

What happens at the check?

You will receive an invitation to a lung health check by text message or letter. You must confirm your appointment.

Your appointment will be by phone. A member of the screening team will ask about your health and lifestyle to find out more about your risk of developing lung cancer. If the check finds you are at a higher risk of developing lung cancer, you may be invited for a low dose CT scan. Having a CT scan is not a cause for concern. Your CT scan will be done in a mobile CT scanning unit located within the community, usually on a car park at a supermarket or retail park.

What happens at the CT scan?

A CT scan is a type of x-ray that takes a detailed picture of your lungs and checks for any signs of lung cancer or lung disease. During the scan, the bed you lie on moves in and out of the scanner. Your head and legs stay outside of the scanner and you do not go into an enclosed space. The scan is usually done in a mobile scanning unit near to where you live to make it as easy as possible for you to attend. It only takes a few minutes and does not hurt. You can also bring a friend or relative with you for support.

When will I receive my results?

You will receive a letter or a call with your results within four weeks of the CT scan. Most results show that the lungs are completely healthy but if the scan shows anything concerning, you may be referred for further lung scans or treatment.

Around 15 out of every 100 people screened have nodules on their lungs. Most nodules are harmless and caused by something else like scarring from a previous chest infection. Around 1 in 100 people who go for a CT scan are diagnosed with lung cancer. If the scan shows nothing of concern, you will be invited back for another scan every two years until you are 75.

A letter with your results is also sent by the team to your GP.

Who cannot have a scan?

There are a number of reasons why a patient might not be offered a low dose CT scan and these include

the person has had a CT scan in the last 12 months
they're unable to lie flat
they're unable to transfer onto the CT scanning bed without support, or with the support of somebody who attends the scan with them
they weigh more than 200kg/31.5 stones
they are not physically fit enough to take part
they do not have capacity to consent to the CT scan and it is not in their best interests to have one.

Can I bring someone along to the scan?

Yes, this is possible but please ask the Lung Cancer Screening team for further information.

More information

For more information on Lung Cancer Screening, see the Cheshire and Merseyside Cancer Alliance website: https://cmcanceralliance.nhs.uk/work/prevention-early-diagnosis/lung-cancer-screening

Looking after your lungs

Your lungs work hard every day so you can breathe. They don’t get much rest because in one day you can breathe up to 25,000 times. They carry oxygen from the air to your blood and release carbon dioxide from your blood into the air. Your body’s cells need this oxygen to work properly.

Your lungs have a natural defence system to keep out dirt and germs, but several things can damage this, meaning they cannot do their job as well.

There are things you can do to look after your lungs – which is especially important if you have a lung condition – including:

stopping smoking
being more active
having a healthy diet
making sure you have all your vaccinations if you are over 65 or have a long-term condition
knowing the warning signs and symptoms of lung conditions, including Chronic Obstructive Pulmonary Diseases (COPD) and lung cancer.

Contact your GP surgery if you are worried about symptoms of lung cancer, such as:

a cough that does not go away after three weeks
an existing cough that changes or gets worse
chest infections that keep coming back
coughing up blood
being short of breath a lot
unexplained tiredness
an ache or pain when breathing or coughing
loss of appetite or unexplained weight loss.

Do not wait for a Lung Cancer Screening appointment if you have any of these symptoms, contact your GP practice for advice.

For people re-invited for a scan. Will I have a lung scan this time?

Not everyone who has a Lung screening needs a lung scan. If you need a scan, we will tell you in your appointment. We will ask you questions in your screening appointment. These questions will help us to work out your risk of developing lung cancer. If you are at low risk, you do not need to have a scan. We might offer you one in the future. This is because your risk can change over time. If you are at high risk, we will offer you an appointment for a scan.

For people re-invited for a scan. Why should I have a Lung check again? Nothing showed up last time I attended.

Lung screening save lives. Lung cancer often does not have any early symptoms. You might not know that anything is wrong until the cancer has spread. When the cancer has spread, it can be harder to treat. Lung screening can help us to find lung cancer early. When we find it early, lung cancer may be cured. Even when lung cancer is found later, it can be treated. We are finding lots of new treatments for lung cancer. Treatments are getting better. Most lung cancers we find through Lung Health Checks are at an early stage. This means that we can treat them more simply and successfully.

Lung Cancer Screening contact details

For appointment enquiries relating to Lung Cancer Screening, please ring 0151 254 3032 or 0151 254 3429.

For Lung Cancer Screening Low Dose CT Scan appointments, please ring 0151 600 1756.

If you are a health professional in primary care, click here for more information on the Lung Cancer Screening programme and see a leaflet for your pratice team below.

You can download these resources for your surgery or team:

GP practice information

Posters

Easy read booklet