Sustained improvement in early lung cancer detection with Targeted Lung Health Check (TLHC) programme

<bold>Introduction:</bold> Doncaster and Bassetlaw, UK, (population 416,000) have high smoking prevalence, social deprivation, and lung cancer mortality. The area's stage I/II lung cancer diagnosis rate was England’s lowest at 23% in 2018. The TLHC programme was launched in Doncaster in 2021 and extended to Bassetlaw in 2022 to enhance early cancer detection. <bold>Aims and Objectives:</bold> This study evaluates the TLHC's effectiveness in increasing the detection of early-stage cancer and the proportion eligible for curative treatment. <bold>Methods:</bold> We analysed the local lung cancer registry for annual data on incidences, staging, and treatment from 2019 (pre-TLHC) to 2021/22 (TLHC) and 2023 (post-initial-CT-TLHC-round), supplementing missing information from multidisciplinary team outcomes and patient records. The TLHC database was matched with the cancer registry to identify detections from the programme. <bold>Results:</bold> The TLHC facilitated 14,000 initial CT scans, resulting in a rise in early-stage (I/II) cancer detection from 27% in 2019 to 35% in 2021, peaking at 42% in 2022, and sustained thereafter at 36% in 2023. Of 379 non-small cell lung cancer cases in 2023, 122 were stage I/II with WHO performance status 0-2, of which 80.32% underwent curative treatments and 53% had surgical resections. A total of 173 individuals met the baseline TLHC screening criteria for age and smoking history; however, only 71 were detected through the programme, suggesting potential for improved public engagement. <bold>Conclusions:</bold> The TLHC programme has resulted in a significant and sustained increase in early-stage lung cancer detection. There is potential for further enhancement through increased public participation.