Improving access and uptake of lung cancer screening with a focus on health inequity: the views of professionals involved in the UK NHS lung cancer screening programme

There is strong evidence that targeted lung cancer screening is effective, but equitable access remains essential to prevent widening health disparities. This study examines the views of professional stakeholders involved in the design and delivery of the UK NHS Lung Cancer Screening Programme (LCSP) with a particular focus on access, uptake and health inequity. Individual semi-structured interviews were conducted with twenty-one professionals involved in the set-up or delivery of LCSP services across England. Data collection took place between May and August 2024. Data were analysed inductively using reflexive thematic analysis. Professionals’ views centred on three themes: (1) Constructing the screening population: identifying eligible individuals for screening related to the accuracy of primary care data, decisions around individuals’ fitness-to-participate and monitoring population uptake; (2) From invitation to participation: design and delivery of screening could differ across services with implications for understanding requirements of screening, decision-making and participation; (3) Raising the profile of lung cancer screening: greater coordination between local networks, teams and service providers was viewed as essential to support awareness, access and uptake. Ensuring equitable lung cancer screening access requires coordinated strategies across the screening pathway, including improved data collection, clearer clinical guidance, greater understanding of population engagement and more awareness across stakeholder groups. Addressing equity-related factors is crucial to ensuring access and uptake of the LCSP as it expands into a population-wide programme across England by 2030.