Early Diagnosis Saves Lives

Receiving a lung cancer diagnosis is devastating news. Lung cancer is the UK’s third most common cancer, with one of the lowest survival rates.¹ Recent analysis has found that the UK ranks 28th out of 33 comparable countries for five-year lung cancer survival.²

Sadly, almost half of all lung cancers are diagnosed at stage IV,³ when they have advanced and are incurable. At stage IV, treatment options are limited, and the prognosis is poor – five-year survival in the UK is at just 5%.⁴

However, the UK is pioneering a step change in this narrative.

In 2023, the UK became one of the first countries in the world to announce the introduction of a national lung cancer screening programme.⁵

The NHS has been developing the blueprint for lung cancer screening for a number of years now through the Targeted Lung Health Check (TLHC) programme.⁶ The evidence from the programme is significant: 76% of lung cancers identified through the programme have been caught at an early stage,⁷ far exceeding the national average of 27.5% in 2021.⁸

Not only this, but evidence is clear that taking a targeted approach to implementation can tackle health inequalities, as highlighted at the recent Health and Social Care Select Committee meeting by Julian Kelly, Deputy Chief Executive Officer and Chief Financial Officer at NHS England:

“Take the example of targeted lung health checks, where we provided ringfenced funding to drive a programme of work that we know improves early cancer diagnosis and saves lives, and which we focused on areas where we know there have been high health inequalities. As a result, we have seen a change in the early cancer diagnosis rate—the first since we started measuring it—and a narrowing of health inequalities.”⁹

Data from the screening programme has showed that people from disadvantaged backgrounds are now most likely to be diagnosed with lung cancer at an early stage – reversing the usual socioeconomic trend in stage at diagnosis.¹⁰

Alongside progress in England, screening pilots are also underway across the devolved nations.^11,12 In Wales, the pilot programme is due to end in March 2025, with initial evaluations already demonstrating a significant opportunity to improve lung cancer outcomes in Wales.¹³

The question for Government now is how to build on these foundations – how can we go further, faster and fairer?

I was delighted to join our AstraZeneca-organised roundtable in the UK Parliament last month to discuss this question with people driving change on the front line: local TLHC leads, clinical experts, patient advocacy groups and parliamentarians.

Two key themes came through from our discussion:

1. Ringfenced national funding

Achieving a successful nationwide screening programme relies on adequate funding. The latest operational planning guidance from NHS England gives local systems more freedom to release ringfenced funds.¹⁴

Whilst the flexibility can enable local decision making based on community need, dedicated funding for lung screening is critical to the continued success of the programme. If we are to truly transform cancer outcomes through screening, ringfenced funding needs to include:

• The screening infrastructure itself, from the local workforce and CT scanner capacity, through to the national IT infrastructure
• The downstream interventions needed to treat patients diagnosed through the screening programme, anticipating the stage shift and subsequent uplift in surgery, radiotherapy and anti-cancer therapies
• Smoking cessation services, which the UK National Screening Programme recommends are integrated into the programme itself to maximise the cost-effectiveness and health opportunity of the service

2. Tailored local implementation

The UK has the right blueprint and experience to make this programme a national success from the outset. Ahead of the roundtable, we spoke to local system leaders who have been implementing targeted lung health checks in their communities. We captured their insights and advice in a case study report, but key success factors included:

• Engaging relevant local stakeholders early and regularly – build strong communication channels to enable joined-up working and streamlined implementation of the programme
• Tailoring the screening programme according to local needs – employ diverse modes of communication and targeted messaging, to ensure engagement across different populations
• Embedding testing sites in the community – utilise accessible locations in the heart of communities, and with good transport links, to improve attendance

You can read our case study report here:

At AstraZeneca, we are proud to contribute to oncology innovation but we recognise that treatments are most effective when cancer is detected early. We are committed to supporting this stage shift, to ensure everyone in the UK benefits from early diagnosis.

With renewed Government commitment, now is the time to act. By leveraging the learnings from pilots and backing national scale up with ringfenced funding, the NHS can create a future where early detection is the norm, not the exception.