Lung Cancer Screening
What is Lung Cancer Screening?
NHS Lung Cancer Screening (LCS), formerly known as Targeted Lung Health Checks, is rolling out across the country, giving people the opportunity to have their lung health checked and have treatment early if any problems are found. Most people will have no problems, but it is best to get checked out.
Lung Cancer Screening is one of the NHS cancer screening programmes and research has identified that people aged 55-74 who have smoked, or who smoked in the past, are at increased risk of lung cancer.
Our programme invites these people for a health assessment over the phone and, if appropriate, a chest CT scan which will take place in a mobile unit within your community.
The programme started in 2019 after a study showed that this screening reduced the number of people dying of lung cancer by 26% in men and between 39% and 61% in women.
Why is Lung Cancer Screening needed?
The NHS is working hard to increase the number of people who survive cancer by finding it earlier, when it is easier to treat and outcomes are more successful.
Lung cancer has often been diagnosed at a late stage because symptoms are not always noticed until the disease has become worse. Lung Cancer Screening is successful in finding cancer in its first stages, when people are much more likely to be cured by treatment.
Cheshire and Merseyside has led the way in rolling out this screening – which was known as Targeted Lung Health Checks – and they have already taken place in areas where lung cancer is more common: Liverpool, Knowsley, Halton, St Helens and south Sefton.
They are now in Wirral and Warrington and north Sefton will follow before the rest of Cheshire. Eventually, they will have taken place in all areas of Cheshire and Merseyside.
More than 500 lung cancers have been diagnosed by these checks – with the majority of people being totally cured of their disease.
Watch this video about why having Lung Cancer Screening is important
Who can attend?
If you are aged 55 to 74 and you smoke, or have previously smoked, you will be sent an appointment for Lung Cancer Screening when the mobile scanning unit is in your area and when it is your turn.
The appointment with the Lung Cancer Screening team will arrive with you in a text message or letter through the post. This appointment will take place over the telephone with a member of the screening team who is specialised in delivering the assessment.
It is important that your GP surgery knows your history of smoking and that it is noted correctly in your NHS records so that you receive a Lung Cancer Screening appointment. If you are not sure if it is noted correctly, please check with your GP surgery.
If you have not been invited for a screening and believe that you are eligible, please contact the team on 0151 254 3032.
What happens at my appointment?
The check takes place on the telephone and takes about 30 minutes to complete. You will be asked a series of questions about your health and lifestyle including any personal or family history of lung cancer, and if you are a current or former smoker. The answers are used to assess your risk of developing lung cancer.
If you are assessed as being at an increased risk of lung cancer, you will be offered a low dose CT scan, which is a type of X-ray that takes an image of your lungs. If you are offered this scan, you will be talked through the benefits and risks of it and you will have the opportunity to ask any questions that you may have. An appointment for your CT scan will be booked.
Your scan is simple and quick will take place in a mobile unit within your community about four weeks after your scan, you will receive your results and your GP will also be told about them. The vast majority of people are totally fine and their lungs are completely healthy.
Watch this video made with the Cheshire and Merseyside Lung Cancer Screening team explaining about the checks:
Here is a video with more information about the lung CT scans
Who is involved?
Liverpool Heart and Chest Hospital is the Lead Provider and is responsible for delivering the Lung Cancer Screening programme across the Cheshire and Merseyside region working in partnership with the Cheshire and Merseyside Cancer Alliance and local NHS teams.
Research
We are a research active Trust.
If you are invited to attend a NHS Lung Health Check (LHC) as part of the Lung Cancer Screening programme, you might also later receive an invitation to take part in a research study. If you wish to opt out of participating in research studies, please inform the team member during your LHC appointment or contact the administration team on 0151 254 3032. This does not affect your participation in the programme.
The following are the current studies that are open involving LHC participants. To find out more please see the additional information and click the associated link.
If you decide after your LHC appointment you would like to opt out please contact the administration team on 0151 254 3032.
Open Studies
P4-LHC Study
If you are invited to attend a NHS Lung Health Check, you might also later receive an invitation to take part in a research study at the University of Liverpool called the P4-LHC study.
More details on P4-LHC can be found here: www.liverpool.ac.uk/p4lhc-study
You do not have to take part in the P4-LHC study and it does not affect your Lung Health Check participation. However, it will require that we share you name and address with the research team to send you the research invitation. You have the right to opt out of participation in the P4-LHC study and the right to decline for your name and address to be shared with the research team.
If you have a Lung Health Check, you will be given the opportunity to opt out of research studies (in which case you will be excluded form P4-LHC).
To opt out of the P4-LHC study, please contact the research team on 0151 600 1876 (between the hours of 9am and 4pm), or email Research.LHCH@lhch.nhs.uk.
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?
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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.
Information for GPs and clinicians
To follow
Lung Cancer Screening Appointments
- 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.