Lung cancer is rarely caught early because it produces few symptoms until it has already spread. The Targeted Lung Health Check (TLHC) programme, now more commonly referred to as the NHS Lung Cancer Screening Programme, was designed specifically to close that gap by finding cancer in current and former smokers before symptoms appear. Several London boroughs have already rolled the checks out, and the early results are the clearest evidence yet that screening changes outcomes.
For a resource built around the legacy of "Better Health for London", this is exactly the kind of prevention infrastructure the original 2014 report argued for: a population-level screening pathway aimed at the people most at risk, delivered close to where they live rather than requiring a hospital referral first.
What the Targeted Lung Health Check actually involves
The programme runs in two stages rather than sending every eligible person straight for a scan. This keeps the process proportionate and avoids unnecessary radiation exposure for people at lower risk.
- A telephone risk assessment. A specialist advisor or lung health check nurse calls to ask about breathing, smoking history, lifestyle, and family medical history. The call typically takes fifteen to twenty-five minutes and is used to calculate an individual risk score.
- A low-dose CT scan, if risk warrants it. Anyone flagged as higher risk is offered a scan, which takes only five to ten minutes and uses a much lower radiation dose than a standard CT. To make attendance easier, many of these scans run from mobile units parked in supermarket car parks or sports stadiums rather than requiring a hospital visit.
Anyone whose scan needs a closer look is contacted directly by the clinical team, and the appointment is also used as an opportunity to offer stop-smoking advice and support, regardless of the scan result.
Who qualifies for a check
Invitations are not sent to the general public. Eligibility depends on all of the following applying:
- Living in an area where the programme currently operates
- Being aged between 55 and 74
- Being registered with a GP surgery
- Being a current or former smoker
Because invitations are generated from GP records, an inaccurate or missing smoking-status entry is the most common reason an eligible person is never contacted — a detail worth flagging to anyone in the target age bracket who has smoked at any point and has not heard from their GP surgery about it.
Where the programme has reached in London
The targeted lung health check is not yet universal across the capital. It is currently offered across all boroughs in North West and South West London, with local health teams inviting residents borough by borough. Roughly 318,000 residents aged 55 to 74 across those two areas are expected to receive an invitation over a three-year rollout period, and national policy has set out plans to extend coverage to the rest of England. For a city with the borough-by-borough variation in health infrastructure this resource has already documented elsewhere, a screening programme that has reached some boroughs years before others is a familiar pattern, not an exception.
What the early results show
The headline case for the programme is the shift in the stage at which lung cancer is actually being found. Before targeted screening existed, most lung cancers were diagnosed too late for curative treatment; the screening pathway has visibly reversed that balance.
| Measure | Before targeted screening | Through the screening programme |
|---|---|---|
| Lung cancers diagnosed at stage 1–2 (potentially curable) | Fewer than 30% | 76% |
| Five-year survival at earliest stage vs. late stage | — | Around 20 times higher |
| Cumulative lung cancers found via the programme | — | More than 5,000 by November 2024; 7,193 by March 2025 |
National figures also point to a broader improvement in early diagnosis: NHS data recorded a 7.4% rise in lung cancer early-diagnosis rates between April 2023 and March 2024 compared with the period before the COVID-19 pandemic. None of this proves the screening programme alone is responsible for every point of that improvement, but the stage-shift within the screened population is direct and substantial.
Why this belongs in London’s prevention story
A scan that finds cancer earlier is only half the value; the phone assessment that precedes it is also a structured opportunity to reach smokers who may not otherwise engage with stop-smoking support. Embedding cessation advice into a screening appointment — rather than a separate service a person has to seek out — is a practical answer to exactly the kind of access barrier that determines whether prevention advice reaches the people who need it most. As the programme continues to expand borough by borough, its progress is one of the more measurable tests of whether London’s health system is delivering the earlier, closer-to-home care the 2014 review called for.