Screening programme helping earlier diagnosis for lung cancer

By Dr Thilan Bartholomeusz, Clinical Director – Lung Cancer Screening Programme, Nottingham & Nottinghamshire.

As a clinician working within the Nottingham and Nottinghamshire Lung Cancer Screening Programme, I’ve seen first-hand how a shift in approach can transform outcomes. When we launched in 2021, lung cancer survival in our communities was among the poorest in the country, largely because too many people were diagnosed too late.

Our goal was simple but ambitious: move from reactive care to prevention and early detection. We began inviting people aged 55–74 who have ever smoked living in Mansfield and Ashfield, even if they felt completely well. Today, that decision is paying off. So far, we’ve carried out over 40,000 scans and diagnosed over 500 cancers, 70% at an early stage. Before screening, that figure was less than 23%. That means more patients can access curative treatment.

We’ve reached over 80% of our target population. What makes me particularly proud is how we’ve done it. By introducing an opt-out invitation system, we’ve normalised screening and achieved uptake rates as high as 75% in some areas, well above the national average.

But numbers only tell part of the story. Much of our success comes from meeting people where they are. Our mobile CT scanners operate in community settings seven days a week, removing barriers like travel, work commitments and anxiety about hospitals.

We’ve also worked hard to reach those often left behind. From drop-in clinics for people experiencing homelessness to tailored support for those with learning disabilities, we’ve adapted our services to fit real lives. Screening appointments have become opportunities to address wider health needs, including smoking cessation, which we offer immediately, when motivation is highest. We have been able to identify patients who would benefit for further investigations to diagnose other underlying chronic illness such as COPD and also advise and signpost patients for NHS Health Checks.

There is more to do, but the direction is clear: when we design services around people, rather than expecting people to fit services, we can change outcomes and lives.