The Targeted Lung Health Check

The TLHC programme aims to find lung cancer early, sometimes before symptoms present. 72% of lung cancer cases are linked to smoking, which makes current or former smokers at a higher risk of developing lung cancer.

Overview

Lung cancer causes more deaths than any other cancer in the UK. There are often no signs or symptoms of lung cancer at an early stage. The TLHC programme aims to find lung cancer early, sometimes before symptoms present. 72% of lung cancer cases are linked to smoking, which makes current or former smokers at a higher risk of developing lung cancer.

Lung health checks are offered to current or former smokers aged 55 to 74 and are currently only available in some parts of England, with the aim of reaching national coverage by March 2029.

What is a lung health check?

At a lung health check appointment a participant is asked questions about their health and lifestyle, for example their smoking history, height and weight. Some locations also offer spirometry. If they reach the risk threshold, the participant will be invited for a CT scan. If they do not reach the risk threshold, they will be discharged from the programme. Current smokers will be given an opt-out referral to a smoking cessation service.

To date, just over 1 million invites have been sent and over 2,500 lung cancers have been found through the programme, 75% of which were diagnosed at stages 1 or 2. This compares to 28.9% of lung cancers being diagnosed at stage 1 or 2 without screening.

Health inequalities and TLHCs

The programme has prioritised rolling out in areas of highest deprivation first, and will continue to expand to the rest of England between now and 2029.

This is helping to reduce health inequalities in cancer outcomes; in April, the programme announced that people living in the most deprived areas of England are now more likely to be diagnosed with lung cancer at an earlier stage, compared to their counterparts in less derived areas. thanks to the success of NHS lung trucks. The data shows that for the first time ever, more than a third of people living in the most deprived fifth of England who were diagnosed with lung cancer, were diagnosed at stage one or two (34.5%) - up from 30% in 2019.

People diagnosed with lung cancer at stages one or two are nearly 20 times more likely to survive for five years or more than those whose cancer is caught at later stages.

Fran, participant

I’m very well aware having smoked on and off all my life, it’s important to make sure your lungs are ok. I’ve always been for bowel and breast checks, so I just saw the lung health check as another check-up.

Participant experience and case studies

Through an independent evaluation of participant experience, 95% of over 12,000 participants surveyed rated their experience positively (good or very good).

You can read case studies from the Roy Castle Lung Cancer Foundation. Below are some examples of our participants, Sandra and Fran, who have shared their story.

“It was after this scan that I went to see the doctor and she explained that I had very early-stage lung cancer and would need surgery to remove it.

“They said it would be keyhole surgery, which was a big relief. They also said that from what they could see, it hadn’t spread. I was still obviously very frightened. It was scary and, even though it had been caught early, all kinds of things go through your head. But I felt so fortunate that it had been caught so early.

“I went into the hospital in March 2022, had the surgery the next day and was back home on Mother’s Day. Less than a week after my operation, I went out for a meal with my daughter to the pub. Within two weeks, I was doing my own cooking and just getting back to normal. That’s how quick my recovery was”.

Fran White, from Newcastle, also attended her TLHC and in May 2022, she was diagnosed with stage one lung cancer. Five weeks after diagnosis, she had surgery and is fully recovered.

“I’m very well aware having smoked on and off all my life, it’s important to make sure your lungs are ok. I’ve always been for bowel and breast checks, so I just saw the lung health check as another check-up.

“It was all very straightforward, I had a call with a nurse first. She asked me a series of questions about my general health. Had I lost any weight? Did I have any breathing problems?

“I then had the CT scan in a mobile unit in a nearby health centre. It was very quick. I was only there for about 10 minutes and then I had the results very quickly too.

“I recovered quickly too and now I just have check-ups every few months. Other than that, you wouldn’t even know I had lung cancer! That’s why I want everyone who is invited to go because it’s helped me, and it could help you”.

Communications and engagement

The NHS England National TLHC Team has been working with the Roy Castle Lung Cancer Foundation on a communications campaign, which includes case studies, posters and social media adverts.
The campaign aims to highlight the importance of detecting lung cancer early, and that often someone suffering from lung cancer will have no signs or symptoms. The campaign has been developed following feedback from people who choose not to attend because they feel their lungs are fine.

Watch Targeted Lung Health Checks - why you should attend even if you feel well on YouTube

How can I help?

As a healthcare professional, you can help in a few different ways:

  • Understanding whether the TLHC programme is live in your area, and if it is, mentioning it in conversations with patients who may be eligible. You could ask them if they’ve received their invitation letter, and if they’d like to consider attending. You can find out more about whether the service is live in your area via the NHS website.
  • If appropriate in your workplace, for example a GP surgery, display our communications assets such as posters or leaflets.
  • Share on social media about the programme, especially if you have a wide-reaching audience. You can use our social media assets, such as those above.
  • Talk to colleagues, friends and family about the TLHC service and encourage others to find out more.
  • For more information, you can contact the NHSE TLHC team at england.tlhc@nhs.net.

Patient and public FAQs

The following FAQs may help you answer questions about TLHC from patients and the public.

 

Currently, lung health checks are for people aged 55-74 who have ever smoked. Lung health checks are proven to be beneficial in medical research in this age group. Below this age we do not have enough evidence that we can achieve definite benefit. However, anyone can get lung cancer so if you have any concerns or are experiencing symptoms, contact your GP immediately.

Currently, lung health checks are for people aged 55-74 who have ever smoked. Lung health checks are proven to beneficial in medical research in this age group. Above this age we do not have enough evidence that we can achieve definite benefit. The main concern is that the risks from treatment and other medical conditions 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 immediately.

Currently, lung health checks are for people aged 55-74 who have ever smoked. This is because they are at a higher risk of lung disease or lung cancer than people who have never smoked. This is based on medical research. Research to show benefits in other settings, such as those who have never smoked, have smoked low amounts, or who have experienced passive smoking, is not yet available. However, anyone can get lung cancer so if you have any concerns or are experiencing symptoms, contact your GP immediately.

Currently, lung health checks are for people aged 55-74 who have ever 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 immediately.

Currently, lung health checks are for people aged 55-74 who have ever smoked. At the lung health check, people who are found to have a higher risk of lung cancer will 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 immediately.

Currently, lung health checks are for people aged 55-74 who have ever smoked. This is because they are at a higher risk of getting lung cancer. There is currently no proof from medical research that an inherited risk of cancer alone can reliably inform who is more at risk of having lung cancer. Smoking history is proven to be the best measure for identifying who should have a lung check because former/current smokers are more likely to develop lung cancer. However, we do take family history into account in the lung health check risk assessment.

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.

It’s completely understandable that you might be a little nervous about having a lung health check but it is really important that you go. You can request that someone comes with you to the appointment, such as a family member or friend. Chances are everything will be ok but if it is lung cancer, catching it early can make all the difference.

Your appointment may be in person, by phone, or online. A health professional will ask about your health and lifestyle to find out more about your risk of developing lung cancer. If the lung health check finds you're at a higher risk of developing lung cancer, you may be invited for a low dose CT scan. This is very common and is not necessarily a cause for concern. Your CT scan will be done in either a local hospital or in a mobile CT unit within the community. The lung health check team will write to you and your GP with details of your results.

Published

04 October 2023

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About

The Targeted Lung Health Check (TLHC) programme is a lung cancer screening service being rolled out nationally. We want to raise awareness of the programme and ask for your support in encouraging participants to attend.

Further resources

Video

Lungs Matter

Respiratory Futures and the British Thoracic Society (BTS) have partnered with ITN Business to produce ‘Lungs Matter’.

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