Is targeted lung cancer screening an opportune time to address cardiovascular risk

Lung cancer and cardiovascular disease (CVD) are both leading causes of mortality and morbidity in the UK and worldwide.1 2 Every day in the UK, approximately 130 people learn that they have lung cancer, and nearly 100 die because of it.3 For CVD, the numbers are even greater; on average, 460 people die each day due to it.4 These are pause for thought statistics that are a call to action for evidence-based public health initiatives that make a difference. In early 2019, NHS England rolled out its targeted screening programme for lung cancer with low-radiation dose CT. At an estimated cost of £70 million, 10 regional community lung health check projects are planned, starting in areas with greatest lung cancer death rates and targeting high-risk individuals.5 6 Central to this initiative was the Macmillan funded Manchester study, which targeted these hard to reach individuals in the community as opposed to established healthcare settings. Health economics analysis indicated this approach was cost-effective, with high rates of early-stage lung cancer detection, which were amenable to radical treatments.7 8 There is ongoing debate, however, about the relative merits of a national targeted lung cancer screening project, particularly in the setting of an already overstretched NHS.9 To this end, rigorous audit and governance of the programme are crucial.5 Interestingly, alongside lung cancer detection, several lung cancer screening studies have also shown their study cohorts are at high risk of CVD.10–12 In this issue of the journal, …