Patient guide · Thoracic imaging
Lung cancer screening, low-dose CT for smokers and former smokers — the NHS Targeted Lung Health Check.
Lung cancer screening uses low-dose CT to detect early lung cancer in high-risk smokers and former smokers. The NHS Targeted Lung Health Check invites people aged 55–74 with a smoking history to reduce lung cancer mortality by ~20%.
Key facts
What lung cancer screening is, at a glance.
Six things worth knowing before you consider a low-dose CT lung screen.
-
Definition
Low-dose CT screening for high-risk smokers and former smokers aged 55–74.
-
NHS pathway
The NHS Targeted Lung Health Check is available in most regions.
-
Mortality benefit
~20% reduction in lung cancer mortality (NLST / NELSON trials).
-
Nodule follow-up
Fleischner Society–guided surveillance for indeterminate nodules.
-
Radiation dose
Typical low-dose CT delivers ~1.5 mSv per scan.
-
MDT-linked
Results feed into a multi-disciplinary team pathway for suspicious findings.
The pathway
From eligibility to plan — what happens, in order.
Seven steps, from checking whether you qualify through to a multi-disciplinary team plan if anything is found.
- 01
Eligibility assessment
Age, pack-year smoking history and risk factors reviewed against Targeted Lung Health Check criteria.
- 02
Consultation and consent
A clinician explains the benefits, limits, incidental findings and next-step pathways.
- 03
No preparation
No fasting, no contrast, no cannula. Wear something without metal on the chest.
- 04
Low-dose CT (10 seconds)
A single breath-hold acquisition on a modern multidetector CT — the scan itself takes about ten seconds.
- 05
AI nodule detection
AI-assisted software flags and measures pulmonary nodules for consultant review.
- 06
Consultant radiologist reporting
A thoracic-imaging consultant reports the scan against Fleischner and BTS criteria.
- 07
MDT plan
Any suspicious finding is discussed at a lung MDT with a written plan back to you and your GP.
What it shows
What a low-dose CT of the chest can reveal.
Screening finds cancers early — and often picks up other clinically important findings along the way.
-
Solitary pulmonary nodule
A single lung nodule, characterised by size, density and morphology for risk.
-
Multiple nodules
Several nodules — pattern and distribution guide benign vs suspicious calls.
-
Suspicious mass
A larger lesion with features that warrant urgent work-up.
-
Emphysema
Smoking-related lung destruction — quantified and reported alongside cancer risk.
-
Interstitial lung disease (ILD)
Fibrotic or inflammatory patterns picked up incidentally on the screen.
-
Coronary calcium (incidental)
A cardiovascular risk signal reported when clearly visible on the low-dose CT.
-
Aortic aneurysm (incidental)
Thoracic aortic dilatation flagged when present, with onward vascular pathway.
-
Red flag: >8mm spiculated nodule — 2WW pathway
Referred urgently through the two-week-wait suspected-cancer route.
Management options
What can happen next — from reassurance to treatment.
The plan depends entirely on what the scan shows. Most people get reassurance or timed follow-up.
-
Reassurance for negative
A clear scan with no significant nodules — return to routine screening interval.
-
Fleischner surveillance
Timed follow-up CT for indeterminate nodules using Fleischner Society criteria.
-
PET-CT
Metabolic imaging to characterise nodules ≥8mm or suspicious lesions.
-
CT-guided biopsy
Percutaneous needle sample of peripheral lesions for histology.
-
Bronchoscopy / EBUS
Endobronchial ultrasound-guided sampling of central lesions and mediastinal nodes.
-
Thoracic surgery
Lobectomy or sublobar resection for confirmed early-stage lung cancer.
-
SABR radiotherapy
Stereotactic ablative radiotherapy for medically inoperable early-stage disease.
-
Chemo / immunotherapy
Systemic therapy for locally advanced or metastatic disease, guided by the lung MDT.
Red flags
Findings that trigger an urgent pathway.
Any of the following moves the scan out of routine screening and into a suspected-cancer or vascular workflow.
-
Spiculated mass
-
Nodule >8mm with growth
-
Cavitating lesion
-
Bulky mediastinal disease
-
Pleural effusion with mass
-
SVC obstruction
-
Bone metastases
-
Adrenal mass
-
Interstitial pneumonia with hypoxia
Frequently asked
Everything we get asked about lung cancer screening.
Eligibility, radiation dose, what happens if a nodule is found, and whether screening actually saves lives.
-
Who is eligible for lung cancer screening?
The NHS Targeted Lung Health Check invites people aged 55–74 who are current or former smokers with a significant smoking history. Private screening can extend to people outside these criteria after risk assessment.
-
How much radiation is involved?
A low-dose CT delivers around 1.5 mSv — roughly six months of natural background radiation, and a fraction of a standard chest CT.
-
Does the scan hurt?
Not at all. You lie on a couch, hold your breath for about ten seconds, and it’s done. No injection, no contrast, no cannula.
-
What happens if a nodule is found?
Most small nodules are benign. Fleischner Society guidance sets the surveillance interval based on size and density. Larger or suspicious nodules move to PET-CT, biopsy or the two-week-wait pathway.
-
Will it pick up things other than lung cancer?
Yes — emphysema, interstitial lung disease, coronary calcification and thoracic aortic dilatation are commonly reported incidental findings, each with its own onward pathway.
-
Does screening actually save lives?
The NLST and NELSON trials show a ~20% reduction in lung cancer mortality in high-risk smokers screened with low-dose CT — the strongest evidence base of any lung cancer screening approach.
Related tests
Looking for a different test?
-
Lung cancer screening CT
The screening CT itself — protocol, technique and reporting.
Learn more -
CT lung assessment
Diagnostic CT of the lungs beyond the screening pathway.
Learn more -
Chest X-ray
The first-line chest imaging test — where it fits and where it doesn’t.
Learn more -
All tests
Browse every test and procedure we arrange.
Learn more -
Asthma
Related condition guide.
Learn more -
COPD
Related condition guide.
Learn more -
Continuous Positive Airway Pressure
Related treatment option.
Learn more -
Complementary Alternative Medicine
Related treatment option.
Learn more
In practice, in London
Why private lung cancer screening moves differently in London
With lung cancer screening, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Waiting lists on the NHS for lung cancer screening vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
A typical private booking for lung cancer screening in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For lung cancer screening specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see lung cancer screening — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.