What is the clinical evidence from this study?

Study design: Observational. Population: High risk for lung cancer (n=10155). Intervention: Sociodemographic and clinical factors. Primary outcome: Screening uptake (attendance at the initial assessment following invitation).

What does this research mean for the field?

Lung cancer screening uptake among high-risk individuals in the UK is 89.6% overall, but is significantly lower among those with rural residence, higher deprivation, older age, and COPD. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 20, 2026

D22-08 Factors Associated With Uptake of Lung Cancer Screening Among High-Risk Individuals in the United Kingdom Using Electronic Health Records

Key Result

Lung cancer screening uptake was 89.6% overall, but significantly lower among individuals with rural residence (AOR 0.25; 95% CI 0.21-0.29) and higher deprivation (AOR 0.69; 95% CI 0.53-0.89).

Key Points

This study aims to identify factors associated with the uptake of lung cancer screening among high-risk individuals in the UK.
Used primary care electronic health records from Clinical Practice Research Datalink Aurum between 2022 and 2025.
Included high-risk individuals aged 55–74 years, defined as current or former smokers invited to the NHS Lung Health Check program.
Applied multivariable logistic regression to assess factors influencing screening uptake.
Overall screening uptake was high at 89.6% among 10,155 eligible individuals.
Lower uptake was associated with older age (≥65 years) (AOR 0.81, 95% CI 0.71–0.93) and higher deprivation (AOR 0.69, 95% CI 0.53–0.89).
Higher uptake was linked to male gender (AOR 1.18, 95% CI 1.04–1.35) and a history of coronary heart disease (AOR 1.49, 95% CI 1.24–1.79).

Study Design

Type

Observational (n=10,155)

Multicenter

Yes

Structured PICO

What factors are associated with the uptake of lung cancer screening among high-risk individuals in the United Kingdom?

Population

10,155 adults aged 55–74 years, identified as current or former smokers, and invited to participate in the NHS Lung Health Check program in the UK. Mean age 64.3 ± 5.5 years, 52.9% male.

Outcome

Uptake of lung cancer screening (defined as attendance at the initial assessment following invitation)

Lung cancer screening uptake among high-risk individuals in the UK is high overall, but targeted interventions are needed to address disparities related to age, deprivation, rural residence, and comorbidities.

Abstract

Abstract Rationale Lung cancer screening (LCS) with low-dose computed tomography has been shown to reduce lung cancer mortality through early detection. However, screening uptake among high-risk individuals remains suboptimal and varies across settings. Evidence regarding factors influencing LCS uptake is inconsistent. This study aimed to identify factors associated with LCS uptake among high-risk individuals in the United Kingdom (UK). Methods We conducted a study using primary care electronic health records from the Clinical Practice Research Datalink Aurum between 2022 and 2025, linked with Hospital Episode Statistics data. High-risk individuals were defined as adults aged 55–74 years, identified as current or former smokers, and invited to participate in the NHS Lung Health Check program. Screening uptake was defined as attendance at the initial assessment following invitation. Multivariable logistic regression was used to determine factors associated with uptake. Results Among 706,223 individuals in our study, 10,155 met the inclusion criteria. The mean age was 64.3 ± 5.5 years, and 52.9% were male. The overall uptake was 89.6%. Lower uptake was associated with older age (≥65 years) (AOR 0.81, 95% CI 0.71–0.93), higher deprivation (IMD quintile 5: AOR 0.69, 95% CI 0.53–0.89), rural residence (AOR 0.25, 95% CI 0.21–0.29), and having chronic obstructive pulmonary disease (COPD) (AOR 0.76, 95% CI 0.65–0.89). Higher uptake was associated with being male (AOR 1.18, 95% CI 1.04–1.35), having coronary heart disease (AOR 1.49, 95% CI 1.24–1.79), and having a history of secondary healthcare utilization (AOR 1.33, 95% CI 1.15–1.55). Conclusions Uptake of lung cancer screening among high-risk individuals in the UK was high overall and varied by sociodemographic and clinical characteristics. Lower uptake was observed among older, less affluent individuals, those living in rural areas, and those with COPD, whereas higher uptake was seen among men, those with coronary heart disease, and individuals with prior healthcare utilization. Tailored interventions should target underserved populations, particularly in rural and deprived areas, to promote equitable access and reduce disparities in LCS uptake. This abstract is funded by: This work was supported by the Imperial BRC and Chulabhorn Royal Academy. This article presents independent research commissioned by the National Institute for Health Research (NIHR) under the Applied Health Research (ARC) programme for North West London. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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