Lung cancer is the leading cause of cancer death in Wales, causing more deaths annually than breast and colorectal cancer combined. Most cases are diagnosed at a late stage, when it is rarely possible to cure the disease. Over time, evidence from trials has grown showing that for people who are at high risk of lung cancer, based on their age and smoking history, screening with low-dose CT (LDCT) scans can diagnose more lung cancers at an early stage and reduce the risk of dying from lung cancer.
Key documents
Lung Health Check Scoping Report (2019)
Lung Health Check Operational Pilot for Wales Evaluation Report 1 (2024)
Lung Health Check Operational Pilot for Wales Evaluation Report 2 (2025)
Scoping
In 2019, the NHS Wales National Cancer Team (formally the Wales Cancer Network) appointed a team to conduct a scoping review exploring the potential for lung cancer screening, or “Lung Health Checks” (LHCs), in Wales. The team included a Clinical Lead (Dr Sinan Eccles, Consultant Respiratory Physician), Project Manager (Claire Wright) and Senior Project Support Officer (Roya Yadollahi). The scoping report was completed in autumn 2020 and made recommendations for the next steps in Wales, including:
Planning and delivering an operational pilot in Wales
Monitoring the progress of the UK National Screening Committee, who make recommendations to ministers and the health services of the UK nations on screening
Undertaking a project to assess smoking status data in primary care in Wales, to inform the optimal strategy to identify people eligible for lung cancer screening
The report was presented to the Cancer Implementation Group in November 2020, which granted approval for the project team to develop a programme approach to develop a LHC Pilot in Wales.
Operational Pilot
Planning for the LHC Operational Pilot for Wales progressed following the initial scoping work. It was agreed that the Pilot would be delivered in the North Rhondda area, in partnership between Cwm Taf Morgannwg University Health Board and the Cancer Network. Funding was provided from a number of sources, including a collaboration of third sector and industry groups. The programme team included Dr Sinan Eccles (Clinical lead), Chris Coslett (Programme manager), Claire Wright (Project manager) and Amy Smith (Project support officer). The team within Cwm Taf Morgannwg UHB also included Dr Timothy Pearce (Radiology lead), Dr Elizabeth Sharkey (Specialty doctor), Lyndsey Haffenden (Specialist nurse) and Julie Thomas (Navigator).
The first invitations for the Pilot were sent in August 2023, and the first screening LDCT scans undertaken in September 2023. The Pilot invited people aged 60-74 years who had ever smoked for a telephone assessment which included determining their future risk of lung cancer and smoking cessation advice and support for people who currently smoked. Those at high risk of developing lung cancer were offered a LDCT screening scan at a mobile scanner based at Ysbyty Cwm Rhondda. The Pilot concluded in 2025 having delivered screening LDCT scans to over 600 people in North Rhondda. Twelve people were diagnosed with lung cancer, with two-thirds diagnosed at stage 1 or 2.
Two evaluation reports relating to the Pilot have been published, concluding that:
Lung cancer screening can be delivered effectively within the Welsh healthcare system
Lung cancer screening is likely to yield benefits similar to those seen in studies, pilots and programmes elsewhere
A lung cancer screening programme would significantly improve lung cancer outcomes compared to current care in Wales
The Pilot was recognised at the 2024 Moondance Cancer Awards, winning the Early Detection and Diagnosis award and the Royal College of Physicians (RCP) Eric Watts Award for Patient Engagement in 2025.
Smoking status data project
Several pieces of work were undertaken by the LHC team to explore the feasibility of using primary care smoking status data to identify people eligible for lung cancer screening. A collaborative study with Cardiff University examined the completeness of primary care data at a small selection of GP practices in Wales, the effect of using different search strategies to identify current and ex-smokers, and explored the use of an automated text message system to update records. This was followed by a larger project through the Bevan Commission’s Cancer Innovation and Improvement Programme, again in collaboration with Cardiff University, which developed and tested a toolkit to allow GP practices to rapidly update smoking status records. .
Subsequent progress towards lung cancer screening in Wales
In 2022, the UK National Screening Committee recommended that LDCT screening should be offered to people at high risk of lung cancer in the four UK nations. In 2024, the Welsh Government requested for Public Health Wales to review and make recommendations on how lung cancer screening could be implemented as a national programme in Wales. This drew heavily on the work delivered by the Cancer Network, with several members of the team who had delivered the Pilot forming part of the team developing the report for Welsh Government.
The report was delivered in early 2025, with the Jeremy Miles MS, Cabinet Secretary for Health and Social Care, subsequently announcing in June 2025 that Wales will develop a national lung cancer screening programme, due to launch in 2027. Public Health Wales are leading the planning and implementation of the programme.