Background Lung cancer screening (LCS) with low-dose CT (LDCT) reduces lung cancer mortality. National implementation is now recommended in England, with government support announced. Following successful UK pilot studies between 2016–2019, NHS England (NHSE) launched the Targeted Lung Health Check (TLHC) programme. This abstract summarises lung cancer detection data from the combined NHSE TLHCs. Methods In 2019, face-to-face or telephone lung health checks (LHCs) commenced for ever-smokers aged 55–74 in underserved populations with high lung cancer mortality. Current smokers are offered Very Brief Advice and cessation referral. Those at higher risk of lung cancer (PLCOm2012 ≥1.51% or LLPv2 ≥2.5%) are offered LDCT reported by quality-assured thoracic radiologists with lung MDT expertise using adapted British Thoracic Society nodule guidelines. The TLHC programme includes several phases of deployment, now incorporating 43 live sites. Site level data are presented for all phase 1 (original), phase 2 (onboarded) sites, and phase 3 (expansion) sites. Results By March 2023, 892,404 people had been invited for a LHC across all TLHC 'live' sites. 377,791 attended a LHC (uptake rate 42.1%) of whom 176,572 were identified as high risk and offered LDCT screening. After DNAs/exclusions, 156,032 (88.4% of referred) participants underwent LDCT screening (LHC to CT conversion rate 41.3%). 2,056 participants have been diagnosed with lung cancer, equating to a prevalence of 1.3%. 75.1% were diagnosed at an early-stage (I-II). Further cancer diagnoses are expected from nodule surveillance. As a proportion of baseline LDCT, surveillance scans had been performed at 3mo (11.3%), and 12mo (5.8%) respectively. In parallel, rapid registration data for lung cancer showed greatest improvement in stage of diagnosis in the most deprived quintile. Conclusions Through the work of a multi-disciplinary team, the NHSE TLHC programme, working across multiple project sites has successfully delivered LCS to high-risk participants across England. This has resulted in increased early stage diagnosis, especially for people experiencing higher deprivation. The programme continues to expand in a phased manner, and will play a key role informing full national LCS roll-out by 2030.

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Background: Cardiovascular disease (CVD) is a major cause of morbidity and mortality in populations eligible for lung cancer screening. The aim of this study was to determine whether a brief CV risk assessment, delivered as part of a targeted community-based lung cancer screening programme, was effective in identifying individuals at high risk who might benefit from primary prevention. Methods: The Manchester Lung Screening Pilot consisted of annual low dose CT (LDCT) over 2 screening rounds, targeted at individuals in deprived areas at high risk of lung cancer (age 55-74 and 6-year risk >= 1.51%, using PLCOM2012 risk model). All participants of the second screening round were eligible to take part in the study. Ten-year CV risk was estimated using QRISK2 in participants without CVD and compared to age ( +/- 5 years) and sex matched Health Survey for England (HSE) controls; high risk was defined as QRISK2 score >= 10%. Coronary artery calcification (CAC) was assessed on LDCT scans and compared to QRISK2 score. Results: Seventy-seven percent (n = 920/1,194) of screening attendees were included in the analysis; mean age 65.6 +/- 5.4 and 50.4% female. QRISK2 and lung cancer risk (PLCOM2012) scores were correlated (r = 0.26, p < 0.001). Median QRISK2 score was 21.1% (IQR 14.9-29.6) in those without established CVD (77.6%, n = 714/920), double that of HSE controls (10.3%, IQR 6.6-16.2; n = 714) (p < 0.001). QRISK2 score was significantly higher in those with CAC (p < 0.001). Screening attendees were 10-fold more likely to be classified high risk (OR 10.2 [95% CI 7.3-14.0]). One third (33.7%, n = 310/920) of all study participants were high risk but not receiving statin therapy for primary CVD prevention. Discussion: Opportunistic CVD risk assessment within a targeted lung cancer screening programme is feasible and is likely to identify a very large number of individuals suitable for primary prevention.