On 28 June, the Welsh Cabinet Secretary for Health and Social Care, Jeremy Miles MS, announced the rollout of a targeted lung cancer screening programme in Wales.  

The announcement comes after years of campaigning and collaboration across the not-for-profit sector, industry and the NHS. Notably, the news follows the dedicated efforts of Welsh clinicians, who’ve helped champion and secure this screening for Welsh communities. 

We’ve worked alongside other health charities to back this important call in Wales. With our partners, we helped launch a petition calling on the Welsh Government to rollout lung cancer screening, which gathered over 5,000 signatures.  Over the past two years, we’ve shown our support through multiple media appearances, evidence submissions, and sustained political campaigning within the Senedd.

In 2019, Dr Sinan Eccles, Clinical Lead of the Lung Health Check Programme, led a successful pilot that was funded by the third sector and industry partners. The pilot took place in the Cwm Taf Morgannwg University Health Board area, which has a higher than average lung cancer prevalence. 

The study had the largest uptake compared to all other Lung Health Check activities across the UK, showing the willingness of the community to participate. The study also demonstrated the potential impact of the wider programme, as two-thirds of people who were diagnosed with lung cancer during the study were diagnosed at an early stage, when their treatment was much more likely to work. 

The pilot demonstrated strong clinical leadership and showed that a national targeted lung cancer screening programme could significantly improve lung cancer outcomes in Wales, as well as reduce smoking rates.

Why does lung screening matter?  

Lung cancer takes more lives than any other type of cancer in Wales, with around 1,800* deaths annually. A key cause of this is late diagnosis, as around 7 in 10** lung cancer patients in Wales with a known stage are diagnosed at stages 3 and 4.  

However, when lung cancer is caught earlier (at stages 1 and 2), there is a better chance of survival. In Wales, almost 6 in 10 (55%) people diagnosed with lung cancer survive their disease for 5 years or more when diagnosed at the earliest stage. This falls to just 3% when diagnosed at the latest stage***.   

The pilot clearly demonstrated that targeted screening could lead to more cancers being diagnosed at an early stage, as 2 in 3 cases of lung cancer diagnosed through the study were in early stages (1 and 2). By contrast, in standard care in Wales, a similar proportion of cases, 70%, are diagnosed later at stages (3 or 4).

Lung cancer disproportionately affects people from more deprived communities and smoking is the main cause, with around 2 out of 3 lung cancer cases in Wales being caused by smoking.  

In Wales, smoking rates are almost three times higher in the most deprived areas compared to the least. A national targeted screening programme designed for people who used to or currently smoke aims to diagnose lung cancer earlier in those at highest risk, particularly in groups disproportionally affected by tobacco related harm.  

Deprived communities often have lower screening uptake. To address health inequalities, it will be important to ensure that informed uptake from these communities is prioritised as implementation plans develop.

What happens next? 

Work will start immediately to develop and introduce a national targeted lung cancer screening programme with an integrated stop smoking service that, once fully implemented, will be available to people aged 55 to 74 who either smoked or currently smoke.  

The screening programme will be delivered in a phased approach across Wales, based on age, starting with the upper age range and gradually reducing it over time. This is the same approach the Welsh Government took for the expansion of the bowel cancer screening programme. 

The Cabinet Secretary for Health and Social Care for the Welsh Government, Jeremy Miles MS, has asked Public Health Wales to move immediately into planning for the rollout to ensure the necessary infrastructure, workforce and support systems are in place, ahead of inviting the first people to take part in screening in 2027. A total of £2.3m in funding for 2025/26 has been agreed to expand the current project team and begin the programme. Once running, it is expected to cost around £13m per year.  

How does this compare with other nations?  

The decision to roll out a national targeted lung screening programme follows the UK National Screening Committee’s (UK NSC) September 2022 recommendation that all UK nations move towards implementing lung cancer screening with an integrated smoking cessation approach.  

Up until now, there has been a disparity in patient access to lung screening across the UK, with screening available only in some parts of England. However, these are currently being rolled out more widely and are expected to be available across England by 2029. While lung screening is being considered in Northern Ireland, there are no firm plans, and scoping work is in the very early stages. The Scottish Government has established a Scottish Expert Advisory Group to develop a business case for implementing a targeted lung screening programme. However, a timeline for introducing such screening in Scotland has not yet been confirmed. 

The rollout of a national lung cancer screening programme in Wales offers a significant opportunity to diagnose cancer earlier, when more treatment options are available. This generally means kinder treatments, less extensive and less expensive, which result in better outcomes for patients as well as the opportunity to reduce smoking rates and address health inequalities. 

To improve lung cancer outcomes further, we would like to see all UK nations adopt national targeted lung cancer screening programmes to catch lung cancer at an earlier stage, help save lives and help people live longer, better lives free from the fear of cancer.