Contribution
It is a pleasure to serve under your chairship, Sir Alec. We will be together all afternoon if you are here for the next debate as well. I welcome this debate on the national lung cancer screening programme. I thank the hon. Member for Wokingham (Clive Jones) for securing it, and for his dedication to anything to do with cancer. The hon. Gentleman has made a name for himself in this House for putting forward these topics. I thank him for his knowledge and for his interest.
The lung cancer screening programme was set up to find lung cancer early, before symptoms appear, especially in people with a history of smoking, who are the group with the highest risk. The UK’s biggest ever early diagnosis initiative for lung cancer, the programme is delivered through targeted lung health checks. The hon. Gentleman referred to how the scheme delivers checks. They take place in local hospitals and in the community, and in vans in settings such as supermarket car parks, so nobody can say they have not had the opportunity to have the check done.
The checks are designed to target those aged 55 to 74 who are current or former smokers, as identified from their GP records, who are registered with a GP and who live in an area where the programme has been rolled out. I understand that the programme is expanding rapidly, region by region and is expected to be fully rolled out across England by 2030. That is welcome. Indeed it is, I would say, almost there.
We do not know how many people have attended the checks, but the United Kingdom National Screening Committee noted that more than 1.9 million have been invited to the programme, which is operating across 25% of England. NHS England has stated that, to date, some 5,037 lung cancers have been detected early since 2019; 76% of those were found at stage 1 or 2. Early-stage diagnosis improves five-year survival nearly twentyfold compared with late-stage diagnosis, so again that is a success of the programme.
The screening programme has been an outstanding success, and I commend the Minister and all those involved in the Department and NHS England on such an extraordinary achievement—they deserve every accolade for it. It has fitted perfectly with the 10-year health plan. We should give credit to the Minister and the Government for the plan and for all they have done to improve health; there are many things they can point to as being successful. It is also nice to see the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), in his place; it would not be a health debate if he and I were not here together—and here we are again.
As chair of the all-party parliamentary group for respiratory health, I warmly welcome the three shifts arising from the 10-year health plan. The screening programme is an excellent example of how well they have worked in practice. The first shift was from analogue to digital: most of the reminders for eligible patients are by text message—that is the new way of doing it; I may not be entirely geared into it, but I understand the process. The second shift was from hospital to community: running the tests in mobile units means they are less intimidating and closer to home. In fact, around 70% of initial screening was delivered via mobile units, improving access in deprived areas where smoking rates are highest. If we want to address the issue, we must go to the coal quay, as we would say, and meet and speak to the people.
The third shift was from treatment to prevention. Early-stage detection dramatically improves survival. The lung checks programme has crucially identified over 100,000 incidental findings of emphysema, one of the key conditions of COPD. However, those incidental findings are not generally followed up, nor do they lead to referrals for further investigation or treatment. Will the Minister ask his Department to consider a follow-up? If incidental findings are identified and there is a chance of curing or addressing the issue, that is the time to strike. The men’s health strategy called for better incidental outcomes, and it contains the ambition of
“ensuring incidental findings from the NHS Lung Cancer Screening programme, including respiratory illnesses such as COPD, are followed up according to the NHS Lung Cancer Screening programme incidental findings protocol and relevant NICE guidance”.
Can the Minister update us on how that is progressing within the men’s health strategy?
We have discussed the outstanding FRONTIER Hull trial with Professor Mike Crooks from Hull, who is piloting an integrated pathway that links screening findings to respiratory assessment and treatment in partnership with the NHS. I commend the work he is undertaking. So far, 383 of the 819 people—47%—recalled to the clinic have received a new diagnosis of COPD and started treatment through a streamlined one-stop clinic, meaning that those patients could begin treatment immediately rather than waiting while their symptoms progressed and their condition deteriorated.
I underline again that it has been shown that a one-stop diagnostic clinic is feasible, can be achieved and fits well with the three shifts. The approach can be tailored to meet local needs, helping integrated care systems to reduce hospital demand and improve patient outcomes. It has been estimated by Chiesi that integrating COPD case finding into lung cancer screening could save the NHS some £33 million over 10 years. That saving cannot be ignored, especially at a time when every pound counts. If it is possible to save some £33 million, it should be in part because of the screening programme.
I urge the Minister to look closely at the outcomes of the trial. This topic deserves a full debate; but more than that, it deserves an outcome. Screening saves lives, ultimately saves money and, importantly, saves needless heartbreak and pain. Let us invest in ourselves and in the process that we are discussing today.