Since 2018 RM Partners has been piloting targeted lung health checks as a pro-active approach to diagnosing lung cancer at an early stage in patients before they develop symptoms.
This initiative invites people identified as being at increased risk of lung cancer due to their age and smoking history, for a lung health check.
Depending on the results, people may then be offered a CT scan in a convenient place, often on the same day.
The project builds on several landmark studies, including the 2018 NELSON study, which has reported a 26% reduction in lung cancer deaths when high-risk patients had a lung health check and CT scan.
Current or ex-smokers aged between 55 and 74 are invited via their GP to attend a lung health check. The health check, led by a respiratory nurse, consists of various tests including checking lung function and respiratory symptoms. A risk assessment tool, in the form of a questionnaire, is used to determine whether the person is at increased risk of lung cancer.
If they are, the person is then offered an appointment for a low dose CT scan, often on the same day. The scans are reviewed and reported back to the patients and their GP within 2-3 weeks. Where appropriate, patients can be referred to hospital or their GP if any follow up is required, as well as to a local stop smoking service.
Our pilot initially involved 17 GP practices with patients in Hammersmith and Fulham invited to Royal Brompton Hospital for their lung health check, and patients in Hillingdon, who were invited to a mobile CT unit in a local supermarket car park – the first of its kind in London.
We published the results of our pilot in the Lung Cancer Journal whereby almost 10,000 people were invited for a lung health check. The pilot replicated national and international studies in finding early cancers as well as a number of conditions such as COPD.
In April 2020, the project became part of the national TLHC pilot and had funding agreed to continue and expand our programme. Since then we have expanded the existing pilot to invite all GP practices in Hammersmith and Fulham and in Hillingdon to participate.
We also launched the programme in Sutton in May 2021, thanks to a partnership of local primary care GP leads, Epsom and St Helier University Hospitals NHS Trust, and the Royal Brompton and Harefield hospitals. We are now offering all eligible patients in Hammersmith and Fulham, Hillingdon, and Sutton a lung health check and CT scan if required, and a second scan after 2 years.
The NHS England targeted lung health check team will evaluate the results of all the programmes taking place across England to use as a basis for further roll out (the national pilot is due to finish in March 2024 with the evaluation reporting in 2025). Any future roll out will then be decided by the National Screening Committee.
Our lung health check programme was paused during the first Covid-19 lockdown but was restarted in July 2020 and has continued to provide lung health checks since then. Changes were made to ensure patient and staff safety, including health checks being carried out by telephone and breathing tests postponed. The hospital and the mobile unit undertake infection control measures, including the use of personal protective equipment and robust cleaning.
For more information please contact Jane Derbyshire, project manager